NPI 1558648709

Kewa Pueblo Health Corporation

Organisation Adolescent and Children Mental Health Clinic/Center Santo Domingo, NM

Practice location

Address: 85 W Highway 22, Santo Domingo, NM 87052-0340
Phone: (505) 465-3060
Fax: (505) 465-1191
Mailing address: PO Box 559, Santo Domingo Pueblo, NM 87052-0559

Authorised official

Name: Vanessa Diana Vigil
Title: Business Office Manager
Phone: (505) 465-3060

Registered specialties

Adolescent and Children Mental Health Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QM0855X

Other Clinic/Center providers in New Mexico →

Registry record

NPI: 1558648709
Entity type: Organization
NPI issued: 15 Nov 2011
Record last updated: 15 Nov 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.