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Organization

ROBERT F. KENNEDY SBHC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BONNIE KAY KAUFMAN RN (SBHC COORDINATOR)
(505) 923-3031
Entity
Organization

Contact information

Practice address
1511 CENTRAL AVE NE, ALBUQUERQUE, NM 87106-4408
(505) 923-3031
Mailing address
1511 CENTRAL AVE NE, ALBUQUERQUE, NM 87106-4408
(505) 923-3031

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101Y00000X
NM
104100000X
Social Worker
Primary
104100000X
NM
251S00000X
Community/Behavioral Health Agency
251S00000X
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1CO1
NM
Enumeration date
01/14/2009
Last updated
01/14/2009
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