Provider Demographics
NPI:1912339714
Name:SOLACE CRISIS TREATMENT CENTER
Entity Type:Organization
Organization Name:SOLACE CRISIS TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILINGUAL ADVOCATE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:GIOANY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIRA-JASSO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:505-988-1951
Mailing Address - Street 1:6601 VALENTINE WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-7301
Mailing Address - Country:US
Mailing Address - Phone:505-988-1951
Mailing Address - Fax:505-988-1906
Practice Address - Street 1:6601 VALENTINE WAY
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-7301
Practice Address - Country:US
Practice Address - Phone:505-988-1951
Practice Address - Fax:505-988-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management