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General NPI Number Information
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NPI Number | 1578881868
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Entity Type | Organization
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Legal Business Name | ALIANZA OF NEW MEXICO
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 1200 S RICHARDSON AVE
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City | ROSWELL
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State | NM
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Zip | 88203-5577
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Country | US
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Telephone | 575-623-1995
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Fax | 575-623-1998
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Provider Business Mailing Address
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Address Line | 1200 S RICHARDSON AVE
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City | ROSWELL
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State | NM
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Zip | 88203-5577
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Country | US
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Telephone | 575-623-1995
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Fax | 575-623-1998
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SASHUA C PATTON
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Credential | MSW
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Telephone | 575-623-1995
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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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