Organization
ALL INDIVIDUALS FIRST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS A ROBERTS MA EDS (OWNER/DIRECTOR)
(505) 501-3647
Entity
Organization
Contact information
Practice address
2101 TRINITY DR, SUITE T, LOS ALAMOS, NM 87544-4102
(505) 501-3647
(505) 662-7404
Mailing address
1332 LA MIRADA CIR, LOS ALAMOS, NM 87544-2767
(505) 501-3647
(505) 662-7404
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
4732111
NM
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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