Organization
AMISTAD MILESTONES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK MORALES (EXECUTIVE DIRECTOR)
(703) 906-1613
Entity
Organization
Contact information
Practice address
3050 N ROADRUNNER PKWY, SUITE A, LAS CRUCES, NM 88011-0833
(575) 523-2288
(575) 523-2299
Mailing address
PO BOX 1090, LAS CRUCES, NM 88004-1090
(575) 523-2288
(575) 523-2299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
I-06859
NM
252Y00000X
Early Intervention Provider Agency
Primary
I-06859
NM
Other
Enumeration date
02/25/2013
Last updated
02/25/2013
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