Healthcare Provider Details

I. General information

NPI: 1912339714
Provider Name (Legal Business Name): SOLACE CRISIS TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 VALENTINE WAY
SANTA FE NM
87507-7301
US

IV. Provider business mailing address

6601 VALENTINE WAY
SANTA FE NM
87507-7301
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-1951
  • Fax: 505-988-1906
Mailing address:
  • Phone: 505-988-1951
  • Fax: 505-988-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: GIOANY LIRA-JASSO
Title or Position: BILINGUAL ADVOCATE SPECIALIST
Credential: B.A.
Phone: 505-988-1951