Organization
MILAGRO DE VIDA COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA R RODRIGUEZ (DIRECTOR)
(575) 650-5767
Entity
Organization
Contact information
Practice address
2249 SANTA ANA, LAS CRUCES, NM 88011-9082
(575) 650-4444
(575) 523-5504
Mailing address
2249 SANTA ANA, LAS CRUCES, NM 88011-9082
(575) 650-4444
(575) 523-5504
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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