Healthcare Provider Details

I. General information

NPI: 1366597908
Provider Name (Legal Business Name): PECOS VALLEY REGIONAL EDUCATION COOP 8
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2218 W GRAND AVE
ARTESIA NM
88210
US

IV. Provider business mailing address

PO BOX 155
ARTESIA NM
88211-0155
US

V. Phone/Fax

Practice location:
  • Phone: 575-748-6100
  • Fax: 575-748-6160
Mailing address:
  • Phone: 575-748-6100
  • Fax: 575-748-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LENA CHAVEZ
Title or Position: DIRECTOR
Credential:
Phone: 575-748-6199