Organization
TRUST IN GOD REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED GONZALES (BOARD PRESIDENT)
(575) 758-3879
Entity
Organization
Contact information
Practice address
489 BLUEBERRY HILL ROAD, EL PRADO, NM 87529
(575) 758-3879
Mailing address
P.O. BOX 6499, TAOS, NM 87511
(575) 758-3879
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M06217
NM
324500000X
Substance Abuse Rehabilitation Facility
Primary
CU00010276
NM
Other
Enumeration date
08/10/2007
Last updated
08/20/2008
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