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Organization

NEW VISTAS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD I GARCIA (EXECUTIVE DIRECTOR)
(505) 471-1001
Entity
Organization

Contact information

Practice address
1205 PARKWAY DR STE A, SANTA FE, NM 87507-6201
(505) 471-1001
(505) 424-4778
Mailing address
1205 PARKWAY DR STE A, SANTA FE, NM 87507-6201
(505) 471-1001
(505) 424-4778

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000D0735
NM
05
000E7214
NM
01
223
NM DEPT OF HEALTH ID
NM
Enumeration date
01/11/2007
Last updated
08/22/2020
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