Healthcare Provider Details

I. General information

NPI: 1619040722
Provider Name (Legal Business Name): CHILDREN, YOUTH & FAMILIES DEPT.-PROTECTIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 PASEO DE PERALTA PERA BUILDING
SANTA FE NM
87501-2747
US

IV. Provider business mailing address

P. O. DRAWER 5160
SANTA FE NM
87502-5160
US

V. Phone/Fax

Practice location:
  • Phone: 505-827-8400
  • Fax: 505-827-8433
Mailing address:
  • Phone: 505-827-8400
  • Fax: 505-827-8433

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: ANGELA ADAMS
Title or Position: DIVISION DIRECTOR-PROTECTIVE SERVIC
Credential:
Phone: 505-827-8400