| Wnmmg-grants Bh | |
|
833 E Roosevelt Ave Grants NM 87020-2115 | |
| (505) 287-2958 | |
| (505) 287-2403 |
| Full Name | Wnmmg-grants Bh |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 833 E Roosevelt Ave, Grants, New Mexico |
| Authorized Official Name and Position | Doug Smith (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 5059825565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wnmmg-grants Bh Po Box 2267 Santa Fe NM 87504-2267 Ph: (505) 982-5565 | Wnmmg-grants Bh 833 E Roosevelt Ave Grants NM 87020-2115 Ph: (505) 287-2958 |
| NPI Number | 1093127045 |
|---|---|
| Provider Enumeration Date | 05/27/2014 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093127045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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