Healthcare Provider Details

I. General information

NPI: 1366332124
Provider Name (Legal Business Name): NEW MEXICO VETERANS INTEGRATION CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 MULBERRY ST SE
ALBUQUERQUE NM
87106-5055
US

IV. Provider business mailing address

2701 MULBERRY ST SE
ALBUQUERQUE NM
87106-5055
US

V. Phone/Fax

Practice location:
  • Phone: 505-296-0800
  • Fax: 505-266-2609
Mailing address:
  • Phone: 505-296-0800
  • Fax: 505-266-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. FERMIN J. ORTEGA
Title or Position: COO
Credential:
Phone: 505-296-0800