Organization
STATE OF NEW MEXICO-ALTSD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS L MOYA (DIVISION DIRECTOR)
(505) 476-4577
Entity
Organization
Contact information
Practice address
2550 CERRILLOS ROAD, SANTA FE, NM 87505
(505) 476-4577
Mailing address
2550 CERRILLOS RD, SANTA FE, NM 87505-3260
(505) 476-4577
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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