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1615 Ojo Court Farmington NM 87401 | |
| (505) 326-2731 | |
| (505) 564-4857 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1615 Ojo Court, Farmington, New Mexico |
| Authorized Official Name and Position | Roberta Lee (CFO) |
| Authorized Official Contact | 5059825565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2267 Santa Fe NM 87504-2267 Ph: (505) 982-5565 | 1615 Ojo Court Farmington NM 87401 Ph: (505) 326-2731 |
| NPI Number | 1932277456 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 10/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932277456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 3050 (New Mexico) | Primary |
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