Provider Demographics
NPI:1619092285
Name:CHILDREN IN NEED OF SERVICES
Entity Type:Organization
Organization Name:CHILDREN IN NEED OF SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-434-3011
Mailing Address - Street 1:501 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6103
Mailing Address - Country:US
Mailing Address - Phone:505-434-3011
Mailing Address - Fax:505-434-9588
Practice Address - Street 1:501 24TH ST
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6103
Practice Address - Country:US
Practice Address - Phone:505-434-3011
Practice Address - Fax:505-434-9588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health