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General NPI Number Information
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NPI Number | 1881551083
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Entity Type | Organization
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Legal Business Name | VALENCIA COUNTY DETENTION CENTER
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 436 COURTHOUSE RD SE
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City | LOS LUNAS
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State | NM
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Zip | 87031-9270
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Country | US
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Telephone | 505-565-8900
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Fax | 505-565-1031
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Provider Business Mailing Address
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Address Line | 436 COURTHOUSE RD SE
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City | LOS LUNAS
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State | NM
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Zip | 87031-9270
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Country | US
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Telephone | 505-565-8900
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Fax | 505-565-1031
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Authorized Official
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Title or Position | WARDEN
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Name | RANDY CHRISTOPHER GUTIERREZ
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Credential |
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Telephone | 505-565-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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