Healthcare Provider Details

I. General information

NPI: 1538100466
Provider Name (Legal Business Name): JEWISH FAMILY SERVICE OF NEW MEXICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 WYOMING BLVD NE SUITE 200
ALBUQUERQUE NM
87109-3238
US

IV. Provider business mailing address

5520 WYOMING BLVD NE SUITE 200
ALBUQUERQUE NM
87109-3238
US

V. Phone/Fax

Practice location:
  • Phone: 505-291-1818
  • Fax: 505-291-0332
Mailing address:
  • Phone: 505-291-1818
  • Fax: 505-291-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ART FINE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-291-1818