Organization
PUEBLO OF ISLETA
Active
Parent organization
PUEBLO OF ISLETA
Other names
Isleta Health Center BH
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUEBLO OF ISLETA
Authorized official
MRS. VOLELLE K ZAMORA (CEO)
(505) 869-4094
Entity
Organization
Contact information
Practice address
01 SAGEBRUSH ST, ISLETA, NM 87022-0000
(505) 869-4863
(505) 869-4811
Mailing address
PO BOX 912157, DENVER, CO 80291-2157
(505) 869-4863
(505) 869-4811
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
501C
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3803775
—
NM
Enumeration date
04/09/2007
Last updated
05/18/2017
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