Organization
WJS NEW MEXICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE MARIE NIKON MA (EXECUTIVE DIRECTOR)
(778) 899-3422
Entity
Organization
Contact information
Practice address
2205 MIGUEL CHAVEZ RD, SUITE F, SANTA FE, NM 87505-6914
(505) 954-1093
Mailing address
2205 MIGUEL CHAVEZ RD, SUITE F, SANTA FE, NM 87505-6914
(505) 954-1093
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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