Organization
SORINITY SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALVINA ROBERTS (EXECUTIVE DIRECTOR)
(505) 629-1712
Entity
Organization
Contact information
Practice address
818 W GRANADA ST, ESPANOLA, NM 87532-2409
(505) 629-1712
(877) 712-4623
Mailing address
4801 LANG AVE NE, SUITE 110, ALBUQUERQUE, NM 87109-4474
(505) 629-1712
(877) 712-4623
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009302900
—
FL
Enumeration date
06/21/2016
Last updated
06/21/2016
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