Organization
CITIZENS FOR THE DEVELOPMENTALLY DISABLED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOBBY LEDOUX (EXECUTIVE DIRECTOR)
(505) 445-5674
Entity
Organization
Contact information
Practice address
230 4TH AVE, RATON, NM 87740-2643
(505) 445-5674
(505) 445-8254
Mailing address
PO BOX 1589, 230 4TH AVE., RATON, NM 87740-1589
(505) 445-5674
(505) 445-8254
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
01135142000
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0208
—
NM
05
—
E7272
—
NM
Enumeration date
02/09/2007
Last updated
02/26/2008
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