Healthcare Provider Details

I. General information

NPI: 1972097897
Provider Name (Legal Business Name): IGW CHILDREN'S HOPE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 SCHOFIELD LN
FARMINGTON NM
87401-7442
US

IV. Provider business mailing address

PO BOX 1353
FARMINGTON NM
87499-1353
US

V. Phone/Fax

Practice location:
  • Phone: 505-787-2143
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH JOSLIN
Title or Position: CEO
Credential:
Phone: 505-787-2143