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Organization

ALTA MIRA SPECIALIZED FAMILY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JIM COPELAND (EXECUTIVE DIRECTOR)
(505) 366-2117
Entity
Organization

Contact information

Practice address
1605 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-5619
(505) 262-0801
(505) 262-0845
Mailing address
1605 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-5619
(505) 262-0801
(505) 262-0845

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
E7208
NM
Enumeration date
08/31/2016
Last updated
08/31/2016
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