Organization
WILSON RESIDENTIAL CARE SERVICES OF NM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWNETTE BURNS (MEMBER)
(505) 896-8509
Entity
Organization
Contact information
Practice address
901 RIO GRANDE BLVD NW STE H260, ALBUQUERQUE, NM 87104-2068
(505) 896-8509
Mailing address
901 RIO GRANDE BLVD NW STE H260, ALBUQUERQUE, NM 87104-2068
(505) 896-8509
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NM
253Z00000X
In Home Supportive Care Agency
—
NM
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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