Organization
CASA DE CORAZON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE MARGARETE WENZKE LMSW (LINCENSED MASTERS OF SOCIAL WORK)
(505) 944-5560
Entity
Organization
Contact information
Practice address
314 DON FERNANDO ST, TAOS, NM 87571-5953
(505) 747-1991
Mailing address
PO BOX 3157, ESPANOLA, NM 87533-3157
(505) 747-1991
(505) 753-6462
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
M-06643
NM
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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