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General NPI Number Information
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NPI Number | 1336430883
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Entity Type | Organization
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Legal Business Name | FAMILY OPTIONS LLC
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 05/02/2011
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Provider Practice Location Address
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Address Line | 518 NMHWY 250
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City | LAS VEGAS
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State | NM
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Zip | 87701-4034
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Country | US
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Telephone | 505-425-5429
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Fax | 505-425-5379
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Provider Business Mailing Address
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Address Line | 518 NMHW 250
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City | LAS VEGAS
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State | NM
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Zip | 87701-4034
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Country | US
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Telephone | 505-425-5429
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Fax | 505-425-5379
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Authorized Official
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Title or Position | CEO
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Name | SHARON L GONZALES
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Credential |
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Telephone | 505-425-5429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 53336356
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License Number State | NM
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