Organization
ARCA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH FRANCIS ALMOND DELEGATED OFFICIAL (ACCOUNTING MANAGER)
(505) 332-6832
Entity
Organization
Contact information
Practice address
1503 4TH ST NW, ALBUQUERQUE, NM 87102-1420
(505) 274-4442
Mailing address
11200 LOMAS BLVD NE, ALBUQUERQUE, NM 87112-5514
(505) 332-6832
(505) 332-6719
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
310400000X
Assisted Living Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15587339
—
NM
Enumeration date
04/30/2019
Last updated
12/23/2019
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