NPI 1255622965
Coyote Canyon Rehabilitation Center, INC.
Practice location
- Address
- 10 Miles East Navajo Route #9, Brimhall, NM 87310
- Phone
- (505) 735-2261
- Fax
- (505) 735-2013
- Mailing address
- PO Box 158, Brimhall, NM 87310-0158
Authorised official
- Name
- Macdonald Avery
- Title
- Executive Director
- Phone
- (505) 735-2002
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1255622965
- Entity type
- Organization
- NPI issued
- 28 Apr 2011
- Record last updated
- 28 Apr 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.