Organization
UNA ALA CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MARTINEZ (EXECUTIVE DIRECTOR)
(505) 747-8187
Entity
Organization
Contact information
Practice address
104 LOS ALAMOS HWY, ESPANOLA, NM 87532-2747
(505) 747-8187
(505) 747-8306
Mailing address
104 LOS ALAMOS HWY, ESPANOLA, NM 87532-2747
(505) 747-8187
(505) 747-8306
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
CSOOO2020217
NM
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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