Organization
YOUTH SHELTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONI KUEHN LMSW (PROGRAM DIRECTOR)
(505) 438-0502
Entity
Organization
Contact information
Practice address
5686 AGUA FRIA ST, SANTA FE, NM 87507-9001
(505) 438-0502
(505) 438-0504
Mailing address
5686 AGUA FRIA ST, SANTA FE, NM 87507-9001
(505) 438-0502
(505) 438-0504
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
M-06966
NM
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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