| Rio Grande Alcoholism Treatment Program | |
|
2301 7th St Las Vegas NM 87701-4966 | |
| (505) 579-4253 | |
| Not Available |
| Full Name | Rio Grande Alcoholism Treatment Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2301 7th St, Las Vegas, New Mexico |
| Authorized Official Name and Position | Lawrence A Medina (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5055794253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rio Grande Alcoholism Treatment Program 2301 7th St Las Vegas NM 87701-4966 Ph: (505) 579-4253 | Rio Grande Alcoholism Treatment Program 2301 7th St Las Vegas NM 87701-4966 Ph: (505) 579-4253 |
| NPI Number | 1992140305 |
|---|---|
| Provider Enumeration Date | 04/30/2013 |
| Last Update Date | 04/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992140305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 101YA0400X (New Mexico) | Primary |
| 251S00000X | Community/behavioral Health | 1754 (New Mexico) | Secondary |
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