NPI 1194213736

Donald Robert Fraga

Practitioner Substance Abuse Rehabilitation Facility Roswell, NM

Practice location

Address: 1107 S Atkinson Ave, Roswell, NM 88203-7154
Phone: (575) 578-4826
Mailing address: 704 Grove St, Roswell, NM 88201-7434

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 0180371 (NM)

Other Substance Abuse Rehabilitation Facility providers in New Mexico →

Registry record

NPI: 1194213736
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Apr 2018
Record last updated: 30 Apr 2018

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.