Organization
CASA MILAGRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE BERNARD (EXECUTIVE DIRECTOR)
(505) 474-7684
Entity
Organization
Contact information
Practice address
49 CAMINO BAJO, SANTA FE, NM 87508-8614
(505) 474-7684
(505) 438-4877
Mailing address
49 CAMINO BAJO, SANTA FE, NM 87508-8614
(505) 474-7684
(505) 438-4877
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
5817
NM
251S00000X
Community/Behavioral Health Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
5817
NM
Other
Enumeration date
02/03/2015
Last updated
06/29/2021
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