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Organization
SEQUEL OF NEW MEXICO, LLC
Active
Organization
SEQUEL OF NEW MEXICO, LLC
Active
Parent organization
SEQUET YOUTH AND FAMILY SERVICES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEQUET YOUTH AND FAMILY SERVICES, LLC
Authorized official
YVONNE R GURULE (DIRECTOR OF MARKETING & CONTRACTS)
(505) 710-9210
Entity
Organization
Contact information
Practice address
1801 RANDOLPH RD SE, ALBUQUERQUE, NM 87106-4230
(505) 924-6330
(505) 768-7956
Mailing address
5400 GIBSON BLVD., SE, SUITE 'A', ALBUQUERQUE, NM 87108
(505) 924-6330
(505) 768-7956
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2020
NM
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
2021
NM
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
2022
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NM#96128259
—
NM
Enumeration date
02/05/2009
Last updated
02/20/2018
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