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Organization

ARCA - CORRALES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. VINCE SMITH (DIRECTOR)
(505) 332-6814
Entity
Organization

Contact information

Practice address
181 EAST LA ENTRADA, CORRALES, NM 87048
(505) 332-6814
(505) 332-6800
Mailing address
11300 LOMAS BLVD NE, ALBUQUERQUE, NM 87112-5512
(505) 332-6814
(505) 332-6800

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5027
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
M4107
NM
Enumeration date
02/22/2007
Last updated
06/04/2021
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