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General NPI Number Information
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NPI Number | 1912448499
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Entity Type | Organization
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Legal Business Name | JENNIFER HARRISON-SANCHEZ
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 9961 ACADEMY RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-4245
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Country | US
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Telephone | 505-321-6009
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Fax |
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Provider Business Mailing Address
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Address Line | 9961 ACADEMY ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114
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Country | US
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Telephone | 505-321-6009
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. JENNIFER MARIE HARRISON-SANCHEZ
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Credential | LMSW
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Telephone | 505-321-6009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | M-08234
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License Number State | NM
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