Provider Demographics
NPI:1669955373
Name:ALDV, LLC
Entity type:Organization
Organization Name:ALDV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LD
Authorized Official - Last Name:VENDRELY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:575-640-0742
Mailing Address - Street 1:PO BOX 3075
Mailing Address - Street 2:
Mailing Address - City:MESILLA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88047-3075
Mailing Address - Country:US
Mailing Address - Phone:575-640-0742
Mailing Address - Fax:
Practice Address - Street 1:4129 CALLE DE ESTRELLAS
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-7649
Practice Address - Country:US
Practice Address - Phone:575-640-0742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-09
Last Update Date:2018-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health