Nm Department Of Health

NPI 1063641819 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1063641819
Enumeration Date 07/14/2009
Last Updated 07/14/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name ALFRED CORONA ALFRED
Position CLINICAL SUPERVISOR
Phone (575) 537-8831
Fax (575) 537-8886
Practice Location
100 CALLE DE CENTRAL
FORT BAYARD NM, 88036, US
Phone (575) 537-8831
Fax (575) 537-8886
Business Location
PO BOX 36216
FORT BAYARD NM, 88036-6216, US
Phone (575) 537-8831
Fax (575) 537-8886
Toxanomy
Taxonomy Code 324500000X
License State New Mexico
License Number 5610
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According to our database, Nm Department Of Health NPI is 1063641819, taxonomy code is 324500000X and license number is 5610, license state is located at New Mexico. Nm Department Of Health physically located at 100 Calle De Central, Fort Bayard NM, 88036. NPI Number 1033115704 has the healthcare provider type.

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1063641819 NPI number is provided on an as is basis without warranty of any kind. 1063641819 is maintained by the National Plan & Provider Enumeration System. The contents of Nm Department Of Health are for informational purposes only.