Organization
PRESBYTERIAN INTEL HEALTH FOR LIFE CENTER
Active
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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