Provider Demographics
NPI:1265825012
Name:STRAIGHT UP MINISTRY, INC
Entity Type:Organization
Organization Name:STRAIGHT UP MINISTRY, INC
Other - Org Name:STRAIGHT UP RECOVERY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:F TOBY
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-320-6830
Mailing Address - Street 1:213 S ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6459
Mailing Address - Country:US
Mailing Address - Phone:505-320-6830
Mailing Address - Fax:
Practice Address - Street 1:213 S ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6459
Practice Address - Country:US
Practice Address - Phone:505-320-6830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health