Organization
THE VICTORIAN HOUSE SLEEP CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO MORENO SR. (OWNER)
(505) 319-9617
Entity
Organization
Contact information
Practice address
4036 CORRALES RD, CORRALES, NM 87048-9308
(505) 319-9617
Mailing address
5109 MENAUL BLVD NE, ALBUQUERQUE, NM 87110-3045
(505) 888-6200
(505) 888-6202
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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