Organization
BERNALILLO COUNTY YOUTH SERVICES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS E. SWISSTACK (DIRECTOR)
(505) 468-7122
Entity
Organization
Contact information
Practice address
5100 2ND ST NW, ALBUQUERQUE, NM 87107-4009
(505) 468-7236
Mailing address
PO BOX 25945, ALBUQUERQUE, NM 87125-0945
(505) 468-7236
(505) 462-9917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9628
NM
363A00000X
Physician Assistant
97PA03
NM
Other
Enumeration date
07/02/2010
Last updated
07/02/2010
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