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General NPI Number Information
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NPI Number | 1174861744
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Entity Type | Organization
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Legal Business Name | ALL FAITHS RECEIVING HOME
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 3001 TRELLIS DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-2937
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Country | US
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Telephone | 271-032-9345
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 TRELLIS DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-2937
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Country | US
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Telephone | 271-032-9345
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Fax |
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Authorized Official
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Title or Position | CCSS ADVOCATE
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Name | MR. BRUCE BATTLE
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Credential |
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Telephone | 505-271-0239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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