Organization
PEANUT BUTTER & JELLY FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAPRICE PINO LADAC (Q&A DIRECTOR)
(505) 877-7060
Entity
Organization
Contact information
Practice address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
Mailing address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-07595
NM
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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