Healthcare Provider Details

I. General information

NPI: 1952487795
Provider Name (Legal Business Name): BERNALILLO PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 N CAMINO DEL PUEBLO
BERNALILLO NM
87004-6146
US

IV. Provider business mailing address

224 N CAMINO DEL PUEBLO
BERNALILLO NM
87004-6146
US

V. Phone/Fax

Practice location:
  • Phone: 505-404-5727
  • Fax: 505-867-7891
Mailing address:
  • Phone: 505-404-5727
  • Fax: 505-867-7891

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: BERNICE LIFE
Title or Position: SPED DIRECTOR
Credential:
Phone: 505-404-5727