Healthcare Provider Details

I. General information

NPI: 1730856832
Provider Name (Legal Business Name): ROSA BIAS CPSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 1ST ST NW
ALBUQUERQUE NM
87102-2355
US

IV. Provider business mailing address

6367 SANDPIPER TRL NE
RIO RANCHO NM
87144-5132
US

V. Phone/Fax

Practice location:
  • Phone: 505-224-9777
  • Fax: 505-224-9779
Mailing address:
  • Phone: 505-582-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: