Organization Name: | PUEBLO OF ZUNI TEEN HEALTH CENTER |
NPI Number: | 1790118446 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARNELLA KUCATE-YEPA (PROGRAM MANAGER) |
Mailing Address: | 02 Twin Buttes Dr Zuni |
State: | NM US |
Postal Code: | 873270000 |
Phone Number: | 5057825719 |
Fax Number: | |
NPI Enumeration Date: | 08/16/2013 |
NPI Last Update Date: | 08/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |