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General NPI Number Information
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NPI Number | 1063612372
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Entity Type | Organization
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Legal Business Name | NEW MEXICO PARENT & CHILD RESOURCES, INC.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 3500 INDIAN SCHOOL RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1143
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Country | US
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Telephone | 505-268-4973
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Fax | 505-268-5056
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Provider Business Mailing Address
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Address Line | 3500 INDIAN SCHOOL RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1143
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Country | US
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Telephone | 505-268-4973
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Fax | 505-268-5056
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ANNE M. DESIDERIO
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Credential | MA, LPCC
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Telephone | 505-268-4973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NM
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