Organization
AGAVE HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CINDY MONZON MBA, MS (HR)
(602) 285-4239
Entity
Organization
Contact information
Practice address
2551 COORS BOULEVARD NORTHWEST, ALBUQUERQUE, NM 87120
(602) 285-4200
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
3454
NM
261QR0800X
Recovery Care Clinic/Center
3454
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06808034
—
NM
05
—
66787718
—
NM
Enumeration date
06/28/2013
Last updated
07/22/2014
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