Organization
SANTA LUCIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CORBITT (DIRECTOR)
(505) 690-2636
Entity
Organization
Contact information
Practice address
519 JOHNSON LN, SANTA FE, NM 87505-2865
(505) 690-2636
Mailing address
PO BOX 1755, SANTA FE, NM 87504-1755
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
03078437009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99171252
—
NM
Enumeration date
12/21/2007
Last updated
12/21/2007
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