| Service Organization For Youth, Inc. | |
|
101 Letton Dr Raton NM 87740-4366 | |
| (575) 445-8568 | |
| (575) 445-0540 |
| Full Name | Service Organization For Youth, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 101 Letton Dr, Raton, New Mexico |
| Authorized Official Name and Position | Ferman Ulibarri (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5754458568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Service Organization For Youth, Inc. Po Box 1165 Raton NM 87740-1165 Ph: (575) 445-8568 | Service Organization For Youth, Inc. 101 Letton Dr Raton NM 87740-4366 Ph: (575) 445-8568 |
| NPI Number | 1700277886 |
|---|---|
| Provider Enumeration Date | 02/11/2015 |
| Last Update Date | 02/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700277886 | NPI | - | NPPES |
| 71525564 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | T-0172211 (New Mexico) | Primary |
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