| Futura Vista Group Home | |
|
1205 Jones St Clovis NM 88101-5540 | |
| (505) 763-5887 | |
| (505) 762-9159 |
| Full Name | Futura Vista Group Home |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1205 Jones St, Clovis, New Mexico |
| Authorized Official Name and Position | William Walker (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5056077774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Futura Vista Group Home 1205 Jones St Clovis NM 88101-5540 Ph: (505) 763-5887 | Futura Vista Group Home 1205 Jones St Clovis NM 88101-5540 Ph: (505) 763-5887 |
| NPI Number | 1750508529 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750508529 | NPI | - | NPPES |
| NM600911 | Other | NM | VALUE OPTIONS PROVIDER ID |
| 130187 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0672 (New Mexico) | Primary |
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