Organization
SAMARITAN HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDE GRANO LPCC (EXECUTIVE DIRECTOR)
(505) 454-1390
Entity
Organization
Contact information
Practice address
220 BERNALILLO ST, LAS VEGAS, NM 87701-3442
(505) 454-1390
Mailing address
220 BERNALILLO ST, LAS VEGAS, NM 87701-3442
(505) 454-1390
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
01256
NM
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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