Healthcare Provider Details

I. General information

NPI: 1780778621
Provider Name (Legal Business Name): BELEN CONSOLIDATED SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N MAIN ST
BELEN NM
87002-3720
US

IV. Provider business mailing address

520 N MAIN ST
BELEN NM
87002-3720
US

V. Phone/Fax

Practice location:
  • Phone: 505-966-1866
  • Fax: 505-966-1865
Mailing address:
  • Phone: 505-966-1866
  • Fax: 505-966-1865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA RAEL
Title or Position: SUPERINTENDENT
Credential:
Phone: 505-966-1866