Organization
YOUTH SHELTERS AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ALAN BLOCK (EXECUTIVE DIRECTOR)
(505) 983-0586
Entity
Organization
Contact information
Practice address
5686 B AGUA FRIA STREET, SANTA FE, NM 87507
(505) 983-0586
(505) 424-0949
Mailing address
P.O. BOX 28279, SANTA FE, NM 87592-8279
(505) 983-0586
(505) 424-0949
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0090881
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000B9298
—
NM
Enumeration date
02/16/2016
Last updated
02/16/2016
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