Organization
LEADERS INDUSTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSTY BAXTER (EXECUTIVE DIRECTOR)
(505) 393-8201
Entity
Organization
Contact information
Practice address
115 W DUNNAM ST, HOBBS, NM 88240-6020
(505) 393-8201
(505) 393-1318
Mailing address
115 W DUNNAM ST, HOBBS, NM 88240-6020
(505) 393-8201
(505) 393-1318
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
02143726002
NM
251S00000X
Community/Behavioral Health Agency
02143726002
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0612
—
NM
05
—
E7425
—
NM
Enumeration date
10/12/2006
Last updated
02/26/2008
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