Organization
ALTA MIRA SPECIALIZED FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM COPELAND (EXECUTIVE DIRECTOR)
(505) 262-0801
Entity
Organization
Contact information
Practice address
1605 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-5619
(505) 262-0801
(505) 262-0845
Mailing address
1605 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-5619
(505) 262-0801
(505) 262-0845
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000D0067
—
NM
05
—
000E7208
—
NM
Enumeration date
12/04/2006
Last updated
02/25/2008
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