Organization
DOOR OF OPPORTUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON M WADDELL (BILLING SPECIALIST)
(575) 736-2040
Entity
Organization
Contact information
Practice address
108 S 14TH ST, ARTESIA, NM 88210-1795
(575) 736-2040
Mailing address
PO BOX 208, ARTESIA, NM 88211-0208
(575) 736-2040
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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