Organization
RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED
Active
Other names
Rio Grande Alcoholism Treatment Program, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE MEDINA (EXECUTIVE DIRECTOR)
(575) 737-5533
Entity
Organization
Contact information
Practice address
105 PASEO DEL CANON W STE A, TAOS, NM 87571-6943
(575) 737-5533
(575) 737-5534
Mailing address
105 PASEO DEL CANON W STE A, TAOS, NM 87571-6943
(575) 737-5533
(575) 737-5534
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
5517
NM
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83774556
—
NM
Enumeration date
07/12/2007
Last updated
03/09/2025
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