| NPI | 1669539656 |
|---|---|
| Former Legal Business Name | SAN JUAN DETOXIFICATION CENTER,INC |
| Entity Type | Organization |
| Authorized Contact | JOLENE MARIE SCHNEIDER Executive Director 505-327-7218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NM 5316) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2013-01-24 |