Healthcare Provider Details

I. General information

NPI: 1346590833
Provider Name (Legal Business Name): RIO RANCHO PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LOMA COLORADO NE
RIO RANCHO NM
87144
US

IV. Provider business mailing address

1600 LOMA COLORADO NE
RIO RANCHO NM
87144
US

V. Phone/Fax

Practice location:
  • Phone: 505-891-5335
  • Fax: 505-891-1180
Mailing address:
  • Phone: 505-891-5335
  • Fax: 505-891-1180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License NumberI-07987
License Number StateNM

VIII. Authorized Official

Name: MRS. JESSICA LYNN FLOERSHEIM
Title or Position: SOCIAL WORKER
Credential: LISW
Phone: 505-891-5335