Provider Demographics
NPI:1376864645
Name:FAITH AND JUSTICE CENTER, INC.
Entity Type:Organization
Organization Name:FAITH AND JUSTICE CENTER, INC.
Other - Org Name:ST.MARY REST HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:FLOOR SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-243-8379
Mailing Address - Street 1:205 7TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3128
Mailing Address - Country:US
Mailing Address - Phone:505-243-5888
Mailing Address - Fax:505-243-5071
Practice Address - Street 1:205 7TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3128
Practice Address - Country:US
Practice Address - Phone:505-243-5888
Practice Address - Fax:505-243-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility