| Canyon Light Inc. | |
|
1301 Cuba Ave Alamogordo NM 88310-5727 | |
| (575) 437-2453 | |
| (575) 443-1504 |
| Full Name | Canyon Light Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1301 Cuba Ave, Alamogordo, New Mexico |
| Authorized Official Name and Position | John P Baldonado (OWNER/PRESIDENT) |
| Authorized Official Contact | 5754306913 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Light Inc. Po Box 114 Alamogordo NM 88311-0114 Ph: (575) 437-2453 | Canyon Light Inc. 1301 Cuba Ave Alamogordo NM 88310-5727 Ph: (575) 437-2453 |
| NPI Number | 1275842478 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 10/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275842478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Mexico) | Primary |
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