Organization
TAOS GROUP HOME, INC.
Active
Other names
Casa de Corazon
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ANTHONY DEPAULA (DIRECTOR OF OPERATIONS)
(505) 751-7037
Entity
Organization
Contact information
Practice address
314 DON FERNANDO ST, POB 2360, TAOS, NM 87571-5953
(575) 751-7037
(575) 751-3010
Mailing address
314 DON FERNANDO ST, TAOS, NM 87571-5953
(575) 751-7037
(575) 751-3010
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
0752
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11034254
—
NM
05
—
84472855
—
NM
05
—
J6668
—
NM
05
—
M1866
—
NM
05
—
R8496
—
NM
Enumeration date
02/07/2007
Last updated
04/10/2009
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