Organization
ROCKY MOUNTAINYOUTH CORPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL TH COLONIUS (EXECUITVE DIRECTOR)
(575) 751-1420
Entity
Organization
Contact information
Practice address
1021 SALAZAR RD, TAOS, NM 87571-8212
(575) 751-1420
(575) 751-1136
Mailing address
PO BOX 1960, 1021 SALAZAR ROAD, RANCHOS DE TAOS, NM 87557-1960
(575) 751-1420
(575) 751-1136
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/16/2009
Last updated
07/16/2009
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