Organization
FAMILY YOUTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRECK ALAN PENROD (BMS PROVIDER)
(505) 117-4203
Entity
Organization
Contact information
Practice address
1320 S SOLANO DR, LAS CRUCES, NM 88001-3758
(575) 556-1669
Mailing address
2190 MARS AVE, 11, LAS CRUCES, NM 88012-8532
(505) 227-4203
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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