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General NPI Number Information
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NPI Number | 1639316540
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Entity Type | Organization
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Legal Business Name | VALENCIA SHELTER FOR VICTIMS OF DOMESTIC VIOLENCE
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 513 BECKER AVE
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City | BELEN
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State | NM
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Zip | 87002-3631
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Country | US
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Telephone | 505-864-3202
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Fax | 505-864-8138
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Provider Business Mailing Address
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Address Line | 513 BECKER AVE
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City | BELEN
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State | NM
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Zip | 87002-3631
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Country | US
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Telephone | 505-864-3202
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Fax | 505-864-8138
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JAMES ANDREW HATFIELD
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Credential |
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Telephone | 505-864-3202
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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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