Provider Demographics
NPI:1366332124
Name:NEW MEXICO VETERANS INTEGRATION CENTERS
Entity type:Organization
Organization Name:NEW MEXICO VETERANS INTEGRATION CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:FERMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-296-0800
Mailing Address - Street 1:2701 MULBERRY ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-5055
Mailing Address - Country:US
Mailing Address - Phone:505-296-0800
Mailing Address - Fax:505-266-2609
Practice Address - Street 1:2701 MULBERRY ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-5055
Practice Address - Country:US
Practice Address - Phone:505-296-0800
Practice Address - Fax:505-266-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty