# VILLA SANTA MARIA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124156815
- **Authorized official:** JOSEPH J MCGUILL (CEO)
- **Authorized official phone:** (505) 281-3609

## Contact information

- **Practice address:** 19 CIRQUELA RD, CEDAR CREST, NM 87008
- **Practice address phone:** (505) 281-3609
- **Practice address fax:** (505) 281-0124
- **Mailing address:** PO BOX 156, CEDAR CREST, NM 87008
- **Mailing address phone:** (505) 281-3609
- **Mailing address fax:** (505) 281-0124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 1114 | NM | Yes |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 1115 | NM | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 1116 | NM | — |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 08/22/2008