Organization
NEW HORIZONS DEVELOPMENTAL CTR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY E KELLY (EXECUTIVE DIRECTOR)
(505) 648-2379
Entity
Organization
Contact information
Practice address
810 E AVE, CARRIZOZO, NM 88301
(505) 648-2379
(505) 648-2370
Mailing address
PO BOX 187, CARRIZOZO, NM 88301
(505) 648-2379
(505) 648-2370
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
5085 CASA DEL SOL
NM
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5086 CASA LINDA
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M4388
—
NM
05
—
M6029
—
NM
Enumeration date
12/14/2006
Last updated
08/22/2020
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