Healthcare Provider Details
I. General information
NPI: 1982551420
Provider Name (Legal Business Name): COMPREHENSIVE AUTISM CARE NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2632 MESILLA ST NE STE 1
ALBUQUERQUE NM
87110-3614
US
IV. Provider business mailing address
2632 MESILLA ST NE STE 1
ALBUQUERQUE NM
87110-3614
US
V. Phone/Fax
- Phone: 719-540-2152
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERIE
TERRANOVA
Title or Position: OPERATIONS DIRECTOR
Credential:
Phone: 719-540-2152