Organization
PRESBYTERIAN INTEL HEALTH FOR LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAY HOLDERMAN (VICE PRESIDENT CDS)
(505) 724-7283
Entity
Organization
Contact information
Practice address
4100 SARA ROAD SE, MSRR5, RIO RANCHO, NM 87124
(505) 253-7900
Mailing address
4100 SARA ROAD SE, MSRR5, RIO RANCHO, NM 87124
(505) 253-7900
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
CL00010876
NM
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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