Healthcare Provider Details

I. General information

NPI: 1639845043
Provider Name (Legal Business Name): CHAVES COUNTY JOY CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 N MONTANA AVE
ROSWELL NM
88201-3380
US

IV. Provider business mailing address

1822 N MONTANA AVE
ROSWELL NM
88201-3380
US

V. Phone/Fax

Practice location:
  • Phone: 575-623-4866
  • Fax: 575-623-0907
Mailing address:
  • Phone: 575-623-4866
  • Fax: 575-623-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MONICA DURAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 575-623-4866