Organization
YOUTH DEVELOPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BACA (BILLING MANAGER)
(505) 212-7393
Entity
Organization
Contact information
Practice address
1111 EASTERDAY DR NE, ALBUQUERQUE, NM 87112-5115
(505) 212-7393
Mailing address
6301 CENTRAL AVE NW, ALBUQUERQUE, NM 87105-2036
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79078851
—
NM
Enumeration date
10/12/2015
Last updated
10/12/2015
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