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General NPI Number Information
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NPI Number | 1437728193
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NEW MEXICO
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY OF NEW MEXICO MSC 07 4250
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-7258
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Fax |
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Provider Business Mailing Address
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Address Line | 1 UNIVERSITY OF NEW MEXICO MSC 07 4250
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-7258
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Fax |
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Authorized Official
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Title or Position | SR. PROGRAM MANAGER
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Name | ELIZABETH VASQUEZ CASTRO
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Credential | MHA
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Telephone | 505-206-0696
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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 |
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