Organization
EPIDAURUS
Active
Other names
Amity Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROD G MULLEN (CEO)
(520) 749-7178
Entity
Organization
Contact information
Practice address
609 GOLD AVENUE SW, ALBUQUERQUE, NM 87102
(505) 246-9300
(505) 246-8905
Mailing address
PO BOX 3043, TUCSON, AZ 85702-3043
(520) 622-6489
(520) 622-6490
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94284267667
DUN
—
Enumeration date
10/02/2006
Last updated
02/09/2016
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