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Organization

YOUTH SHELTERS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JANICE LEVERING (RESIDENT ASSISTANT)
(505) 983-0586
Entity
Organization

Contact information

Practice address
5686 AGUA FRIA ST, SANTA FE, NM 87507-9001
(505) 983-0586
(505) 424-0949
Mailing address
PO BOX 28279, SANTA FE, NM 87592-8279
(500) 598-3058
(505) 424-0949

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
10/05/2009
Last updated
10/19/2009
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