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Organization
SAN JUAN CENTER FOR INDEPENDENCE
Active
Organization
SAN JUAN CENTER FOR INDEPENDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY DEAN CARVER (CHIEF FINANCIAL OFFICER)
(505) 566-5827
Entity
Organization
Contact information
Practice address
1204 SAN JUAN BLVD, FARMINGTON, NM 87401-2724
(505) 566-5827
(505) 566-5842
Mailing address
1204 SAN JUAN BLVD, FARMINGTON, NM 87401-2724
(505) 566-5827
(505) 566-5842
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NM
Other
Enumeration date
08/19/2006
Last updated
10/26/2015
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