# FULLCIRCLE COMMUNITY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** none
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912720335
- **Authorized official:** MATTHEW MOLINA (PRESIDENT & CEO)
- **Authorized official phone:** (505) 414-1162

## Contact information

- **Practice address:** 6136 4TH ST NW STE C, LOS RANCHOS, NM 87107-5367
- **Practice address phone:** (505) 414-1162
- **Mailing address:** 6136 4TH ST NW STE C, LOS RANCHOS, NM 87107-5367
- **Mailing address phone:** (505) 414-1162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 373H00000X | Day Training/Habilitation Specialist | — | NULL | — |
| 373H00000X | Day Training/Habilitation Specialist | — | — | — |

## Other

- **Enumeration date:** 11/04/2024
- **Last updated:** 02/26/2025