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General NPI Number Information
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NPI Number | 1104336874
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Entity Type | Organization
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Legal Business Name | HIGHLINE ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 1475 CENTRAL AVE STE 220
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City | LOS ALAMOS
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State | NM
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Zip | 87544-4207
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Country | US
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Telephone | 505-660-4383
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Fax |
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Provider Business Mailing Address
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Address Line | 2175A 37TH STREET
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City | LOS ALAMOS
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State | NM
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Zip | 87544
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Country | US
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Telephone | 505-695-1460
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Fax |
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Authorized Official
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Title or Position | TRUSTEE
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Name | KRISTIN MARIA RABER
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Credential | LISW
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Telephone | 505-660-4383
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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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