Organization
THE JERICHO HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD ANTHONY GIBBS ORDINATION (PASTOR/DIRECTOR)
(575) 915-0450
Entity
Organization
Contact information
Practice address
2845 DONA ANA RD, LAS CRUCES, NM 88007-5239
(575) 915-0450
(575) 915-0450
Mailing address
2845 DONA ANA RD, LAS CRUCES, NM 88007-5239
(575) 915-0450
(575) 915-0450
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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