Organization
PERFECTLY IMPERFECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC JOHN CAGLIOSTRO LCSW (CEO)
(505) 465-9117
Entity
Organization
Contact information
Practice address
146 QUINCY ST NE, ALBUQUERQUE, NM 87108-1257
(505) 550-1306
(844) 434-8055
Mailing address
146 QUINCY ST NE, ALBUQUERQUE, NM 87108-1257
(505) 550-1306
(844) 434-8055
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/26/2022
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