Organization
PMS DBA ROUNDTREE CHILDRENS' DEVELOPMENT SERVICES
Active
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
Update your record
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