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Organization
ARCA - PARK
Active
Organization
ARCA - PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VNCE SMITH (DIRECTOR)
(505) 332-6814
Entity
Organization
Contact information
Practice address
1120 LOUISIANA BLVD SE, ALBUQUERQUE, NM 87108-5009
(505) 332-6814
(505) 332-6800
Mailing address
11300 LOMAS BLVD NE, ALBUQUERQUE, NM 87112-5512
(505) 332-6814
(505) 332-6800
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5021
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M5013
—
NM
Enumeration date
02/20/2007
Last updated
06/04/2021
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