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Organization
NEW MEXICO DEPARTMENT OF HEALTH
Active
Organization
NEW MEXICO DEPARTMENT OF HEALTH
Active
Other names
Los Lunas Community Program
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLYN BLAINE (FINANCE DIRECTOR)
(505) 264-5456
Entity
Organization
Contact information
Practice address
84 ESTANCIA ROAD, BELEN, NM 87002
(505) 864-4015
(505) 841-5316
Mailing address
445 CAMINO DEL REY SW, SUITE A, LOS LUNAS, NM 87031
(505) 222-0900
(505) 222-0933
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5240
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M2402
—
NM
Enumeration date
12/13/2006
Last updated
02/24/2025
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