Healthcare Provider Details

I. General information

NPI: 1669505962
Provider Name (Legal Business Name): SILVER CONSOLIDATED SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N SWAN ST
SILVER CITY NM
88061-5853
US

IV. Provider business mailing address

2810 N SWAN ST
SILVER CITY NM
88061-5853
US

V. Phone/Fax

Practice location:
  • Phone: 505-956-2000
  • Fax: 505-956-2055
Mailing address:
  • Phone: 505-956-2000
  • Fax: 505-956-2055

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: AIMEE M. JAUREQUI
Title or Position: MEDICAID COORDINATOR
Credential: RN
Phone: 505-956-2090