Provider Demographics
NPI:1336445295
Name:ALBUQUERQUE CENTER FOR THE TREATMENT OF EATING DISORDERS
Entity Type:Organization
Organization Name:ALBUQUERQUE CENTER FOR THE TREATMENT OF EATING DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FINLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:505-266-6121
Mailing Address - Street 1:11930 MENAUL BLVD NE
Mailing Address - Street 2:SUITE 224-C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2478
Mailing Address - Country:US
Mailing Address - Phone:505-266-6121
Mailing Address - Fax:
Practice Address - Street 1:11930 MENAUL BLVD NE
Practice Address - Street 2:SUITE 224-C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2478
Practice Address - Country:US
Practice Address - Phone:505-266-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty