Organization
DESERT VISTA COUNSELING AND BEHAVIORAL HEALTH SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUILLERMO GOMEZ JR. (CEO)
(915) 355-0497
Entity
Organization
Contact information
Practice address
229 ANGELINA, CHAPARRAL, NM 88081-7558
(915) 355-0497
Mailing address
229 ANGELINA, CHAPARRAL, NM 88081-7558
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
251800000X
NM
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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