Organization
NEW MEXICO DEPARTMENT OF HEALTH
Active
Other names
Los Lunas Community Program
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLYN BLAINE (FINANCE DIRECTOR)
(505) 264-5456
Entity
Organization
Contact information
Practice address
84 ESTANCIA ROAD, BELEN, NM 87002
(505) 864-4015
(505) 841-5316
Mailing address
445 CAMINO DEL REY SW, SUITE A, LOS LUNAS, NM 87031
(505) 222-0900
(505) 222-0933
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5240
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M2402
—
NM
Enumeration date
12/13/2006
Last updated
02/24/2025
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