Organization
YOUTH SHELTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SANTOS (RESIDENT ASSISTANT)
(505) 983-0586
Entity
Organization
Contact information
Practice address
5686 AGUA FRIA ST, SANTA FE, NM 87507-9001
(505) 983-0586
(505) 424-0949
Mailing address
PO BOX 28279, SANTA FE, NM 87592-8279
(505) 983-0586
(505) 424-0949
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/05/2009
Last updated
10/06/2009
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