Provider Demographics
NPI:1871045120
Name:JUNTOS PODEMOS INC II
Entity Type:Organization
Organization Name:JUNTOS PODEMOS INC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:SUBSTANCE ABUSE ASSI
Authorized Official - Phone:505-234-9614
Mailing Address - Street 1:5836 IRVING BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4839
Mailing Address - Country:US
Mailing Address - Phone:505-234-9614
Mailing Address - Fax:505-242-4240
Practice Address - Street 1:2715 4TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1329
Practice Address - Country:US
Practice Address - Phone:505-242-4533
Practice Address - Fax:505-242-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3659101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty