| Organization Name: | SAN CRISTOBAL TREATMENT CENTER |
| NPI Number: | 1336442854 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE JOSEPH (CEO) |
| Mailing Address: | 176 Camino Del Medio San Cristobal |
| State: | NM US |
| Postal Code: | 87564 |
| Phone Number: | 5757762524 |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2010 |
| NPI Last Update Date: | 03/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |