Organization
SERVICE ORGANIZATION FOR YOUTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERMAN L. ULIBARRI LMSW (EXECUTIVE DIRECTOR)
(575) 445-8568
Entity
Organization
Contact information
Practice address
101 LETTON DR, RATON, NM 87740-4366
(575) 445-8568
(575) 445-0540
Mailing address
PO BOX 1165, RATON, NM 87740-1165
(575) 445-8568
(505) 445-0540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3834
NM
101YM0800X
Mental Health Counselor
0108381
NM
101YM0800X
Mental Health Counselor
0108891
NM
101YM0800X
Mental Health Counselor
2472
NM
1041C0700X
Clinical Social Worker
I-04932
NM
1041C0700X
Clinical Social Worker
M-06832
NM
1041C0700X
Clinical Social Worker
M-07045
NM
1041C0700X
Clinical Social Worker
Primary
M-4177
NM
1041C0700X
Clinical Social Worker
X-06096
NM
1041C0700X
Clinical Social Worker
X-06579
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71525564
—
NM
Enumeration date
01/15/2007
Last updated
05/26/2010
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