Organization
YOUR MISSING PIECE PSR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S RIOS (CLINICAL DIRECTOR/CEO)
(505) 600-3981
Entity
Organization
Contact information
Practice address
222 LA VETA DR NE, ALBUQUERQUE, NM 87108-1615
(505) 600-3981
Mailing address
222 LA VETA DR NE, ALBUQUERQUE, NM 87108-1615
(505) 600-3981
(184) 478-4864
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1T3556
NM
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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