Organization
ANGELA CHAVEZ
Active
Other names
Premier Developmental Services
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA TERESA CHAVEZ (OWNER/CEO)
(575) 420-9541
Entity
Organization
Contact information
Practice address
607 S LEA AVE, ROSWELL, NM 88203-4567
(575) 420-9541
Mailing address
607 S LEA AVE, ROSWELL, NM 88203-4567
(575) 420-9541
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/26/2013
Last updated
05/26/2013
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