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Organization
SERVICE ORGANIZATION FOR YOUTH, INC.
Active
Organization
SERVICE ORGANIZATION FOR YOUTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERMAN ULIBARRI LMSW, LSAA (EXECUTIVE DIRECTOR)
(575) 445-8568
Entity
Organization
Contact information
Practice address
101 LETTON DR, RATON, NM 87740-4366
(575) 445-8568
(575) 445-0540
Mailing address
PO BOX 1165, RATON, NM 87740-1165
(575) 445-8568
(575) 445-0540
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0172211
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71525564
—
NM
Enumeration date
02/11/2015
Last updated
02/11/2015
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