Organization
ZIA ADVANCED BEHAVIOR ANALYTIC SERVICES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY RICHMOND MANCIL PH.D., BCBA-D (OWNER/THERAPY DIRECTOR)
(575) 430-1823
Entity
Organization
Contact information
Practice address
117 SIERRA BLANCA AVE, TULAROSA, NM 88352-2029
(575) 430-1823
Mailing address
117 SIERRA BLANCA AVE, TULAROSA, NM 88352-2029
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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