Organization
TRANSITIONAL LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY JACKSON (EXECUTIVE DIRECTOR)
(505) 268-5295
Entity
Organization
Contact information
Practice address
5601 DOMINGO RD NE, ALBUQUERQUE, NM 87108-1610
(505) 268-5295
(505) 268-9967
Mailing address
5601 DOMINGO RD NE, ALBUQUERQUE, NM 87108-1610
(505) 268-5295
(505) 268-9967
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
I05341
NM
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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