Provider Demographics
NPI:1558508739
Name:RAPE CRISIS CENTER OF CENTRAL NEW MEXICO
Entity Type:Organization
Organization Name:RAPE CRISIS CENTER OF CENTRAL NEW MEXICO
Other - Org Name:ALBUQUERQUE RAPE CRISIS CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:505-266-7711
Mailing Address - Street 1:9741 CANDELARIA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-1401
Mailing Address - Country:US
Mailing Address - Phone:505-266-7711
Mailing Address - Fax:505-268-5046
Practice Address - Street 1:9741 CANDELARIA RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1401
Practice Address - Country:US
Practice Address - Phone:505-266-7711
Practice Address - Fax:505-268-5046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251B00000XAgenciesCase Management