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NEW MEXICO DEPARTMENT OF HEALTH

Intermediate Care Facility, Mentally Retarded

Belen, New Mexico

Provider NPI: 1124189048

Organization Information:
Organization Name:  NEW MEXICO DEPARTMENT OF HEALTH


Practice Location:
84 ESTANCIA ROAD  BELEN, NM 87002 US
Tel: 505-864-4015  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
NM5240

Other Provider Identifiers:

IssuerNumberStateType
M2402NM05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS NM - Page 1



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