Healthcare Provider Details

I. General information

NPI: 1417873225
Provider Name (Legal Business Name): TRANSGENDER RESOURCE CENTER OF NEW MEXICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 4TH ST NW
ALBUQUERQUE NM
87102-1420
US

IV. Provider business mailing address

PO BOX 80872
ALBUQUERQUE NM
87198-0872
US

V. Phone/Fax

Practice location:
  • Phone: 505-895-4458
  • Fax:
Mailing address:
  • Phone: 505-895-4458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIK WOLF
Title or Position: CO-DIRECTOR
Credential:
Phone: 505-895-4458