Provider Demographics
NPI:1720206113
Name:HUMAN RESOURCE DEVELOPMENT ASSOCIATES, INC.
Entity Type:Organization
Organization Name:HUMAN RESOURCE DEVELOPMENT ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:575-758-0670
Mailing Address - Street 1:1335 GUSDORF ROAD
Mailing Address - Street 2:BUILDING E
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-5204
Mailing Address - Country:US
Mailing Address - Phone:575-758-0670
Mailing Address - Fax:575-751-3557
Practice Address - Street 1:1335 GUSDORF RD
Practice Address - Street 2:BUILDING E
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5204
Practice Address - Country:US
Practice Address - Phone:575-758-0670
Practice Address - Fax:575-751-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty