Organization
PMS DBA ROUNDTREE CHILDRENS' DEVELOPMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG SMITH (EXECUTIVE VICE PRESIDENT)
(505) 982-5565
Entity
Organization
Contact information
Practice address
608 REILLY AVE, FARMINGTON, NM 87401-2634
(505) 443-4303
(505) 443-8311
Mailing address
608 REILLY AVE, FARMINGTON, NM 87499
(505) 327-7720
(505) 992-4990
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7132
—
NM
Enumeration date
01/05/2007
Last updated
04/07/2022
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