Organization
MUGSHOT MUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL MARIE BLANTON (FOUNDER & EXECUTIVE DIRECTOR)
(505) 785-1155
Entity
Organization
Contact information
Practice address
50 SAN PABLO LN, EDGEWOOD, NM 87015-6836
(505) 785-1155
(505) 785-1155
Mailing address
PO BOX 1207, EDGEWOOD, NM 87015-1207
(505) 785-1155
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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