Healthcare Provider Details

I. General information

NPI: 1033458088
Provider Name (Legal Business Name): RIO RANCHO PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2287 LEMA RD SE
RIO RANCHO NM
87124-3989
US

IV. Provider business mailing address

500 LASER RD NE
RIO RANCHO NM
87124-4517
US

V. Phone/Fax

Practice location:
  • Phone: 505-892-1100
  • Fax: 505-892-9728
Mailing address:
  • Phone: 505-892-1100
  • Fax: 505-892-9728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM-06178
License Number StateNM

VIII. Authorized Official

Name: MRS. CARINA PALMER
Title or Position: SOCIAL WORKER
Credential: LMSW
Phone: 505-832-1100