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General NPI Number Information
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NPI Number | 1093029274
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Entity Type | Organization
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Legal Business Name | VISTAS SIN LIMITES @ NMHU
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 1031 11TH ST SUITE 133 AND ROOM 123
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City | LAS VEGAS
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State | NM
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Zip | 87701
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Country | US
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Telephone | 505-454-3509
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 ELEVENTH ST SUITE 123 &133
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City | LAS VEGAS
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State | NM
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Zip | 87701
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Country | US
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Telephone | 505-454-3509
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Fax | 505-454-3524
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JAMES M ALARID
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Credential | PHD
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Telephone | 505-454-3509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NM
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Taxonomy #3
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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 |
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