NPI 1255636221

Onyx Supportive Living LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Albuquerque, NM

Practice location

Address: 5301 Crooked Creek Ave NW, Albuquerque, NM 87114-4193
Phone: (505) 792-1996
Fax: (505) 899-8251
Mailing address: 708 Sandy Dr NW, Albuquerque, NM 87120-3211

Authorised official

Name: Melvin D Parker
Title: Co-Owner
Phone: (505) 720-2273

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 03159603007 (NM)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in New Mexico →

Registry record

NPI: 1255636221
Entity type: Organization
NPI issued: 21 Jan 2011
Record last updated: 21 Jan 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.