Organization
STATE OF NEW MEXICO
Active
Other names
New Mexico Behavioral Health Institue at Las Vegas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R. JARAMILLO (FINANCE DIRECTOR)
(505) 454-2306
Entity
Organization
Contact information
Practice address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-2100
Mailing address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-2100
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
32D0653275
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52431
—
NM
Enumeration date
05/29/2007
Last updated
04/30/2009
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