Kewa Pueblo Health Corporation
NPI #1558648709 in Santo Domingo, New Mexico
Provider Information
- NPI Number
- 1558648709
- Entity Type
- Organization
- Organization Name
- Kewa Pueblo Health Corporation
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- KEWA PUEBLO HEALTH CORPORATION
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- Nov 15, 2011
- Last Updated
- Nov 15, 2011
Practice Location
- Address
- 85 W HIGHWAY 22
- City
- Santo Domingo
- State
- New Mexico
- ZIP Code
- 87052-0340
- Phone
- (505) 465-3060
Authorized Official
- Name
- VANESSA DIANA VIGIL
- Title
- BUSINESS OFFICE MANAGER
- Phone
- (505) 465-3060
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
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