Organization
SOUTHWEST SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN MARCOS BUNTON (CEO)
(505) 264-6786
Entity
Organization
Contact information
Practice address
712 BRANDING IRON ST SE, ALBUQUERQUE, NM 87123-5101
(505) 264-6786
Mailing address
712 BRANDING IRON ST SE, ALBUQUERQUE, NM 87123-5101
(505) 264-6786
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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