CHARLES BACA

SANTA FE, NM
NPI1659563609
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  0064141)
Enumeration Date2007-08-14
Last Update Date2007-08-14
Business Address
-- CHARLES BACA LADAC
1441 S SAINT FRANCIS DR
SANTA FE, NM 87505-4037
Phone number: 505-982-2271
Mailing Address
-- CHARLES BACA LADAC
617 JACKSON AVE APT B
GRANTS, NM 87020-2908
Phone number: 505-982-8870
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