Organization
FULLCIRCLE COMMUNITY SERVICES
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MOLINA (PRESIDENT & CEO)
(505) 414-1162
Entity
Organization
Contact information
Practice address
6136 4TH ST NW STE C, LOS RANCHOS, NM 87107-5367
(505) 414-1162
Mailing address
6136 4TH ST NW STE C, LOS RANCHOS, NM 87107-5367
(505) 414-1162
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
11/04/2024
Last updated
02/26/2025
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