Organization
SOCORRO COUNTY COMMUNITY ALTERNATIVES PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALITA G MALONEY PHD (CLINICAL SUPERVISOR)
(505) 792-6726
Entity
Organization
Contact information
Practice address
106 CENTER ST, SOCORRO, NM 87801-4559
(575) 838-0998
(575) 838-0244
Mailing address
106 CENTER ST, SOCORRO, NM 87801-4559
(575) 838-0998
(575) 838-0244
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275551855
NPI
AK
01
—
1649569575
NPI
NM
01
—
1891046314
NPI
NM
Enumeration date
07/14/2021
Last updated
07/14/2021
Update your record
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