Coyote Canyon Rehabilitation Center, Inc.
NPI #1255622965 in Brimhall, New Mexico
Provider Information
- NPI Number
- 1255622965
- Entity Type
- Organization
- Organization Name
- Coyote Canyon Rehabilitation Center, Inc.
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Apr 28, 2011
- Last Updated
- Apr 28, 2011
Practice Location
- Address
- 10 MILES EAST NAVAJO ROUTE #9
- City
- Brimhall
- State
- New Mexico
- ZIP Code
- 87310
- Phone
- (505) 735-2261
Authorized Official
- Name
- MR. MACDONALD AVERY
- Title
- EXECUTIVE DIRECTOR
- Phone
- (505) 735-2002
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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