Organization
INTERFAITH-LEAP INC.
Active
Other names
interfaith-leap inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND M CHAVEZ ETC (EXCUTIVE DIRECTOR)
(505) 351-2163
Entity
Organization
Contact information
Practice address
JOHN HYSON DR., CHIMAYO, NM 87522
(505) 351-2163
(505) 351-2446
Mailing address
PO BOX 3220, FAIRVIEW, NM 87533-3220
(505) 351-2163
(505) 351-2446
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
NM600922
NM
Other
Enumeration date
12/27/2006
Last updated
04/22/2009
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