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Organization
AMIKIDS SANDOVAL, INC.
Active
Organization
AMIKIDS SANDOVAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY BRACKMAN (VICE PRESIDENT, SUPPORT SERVICES)
(813) 887-3300
Entity
Organization
Contact information
Practice address
851 ANDREA DR STE 4, FARMINGTON, NM 87401-6726
(505) 220-1258
(505) 592-1141
Mailing address
851 ANDREA DR BLDG E, FARMINGTON, NM 87401-6726
(505) 346-0075
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
06/21/2017
Last updated
03/23/2026
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