Healthcare Provider Details

I. General information

NPI: 1942349469
Provider Name (Legal Business Name): GREGORY & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/09/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 CAVALRY ROAD
TAOS NM
87571
US

IV. Provider business mailing address

931 CALLE CONQUISTADOR
TAOS NM
87571-4346
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-2902
  • Fax:
Mailing address:
  • Phone: 575-758-2902
  • Fax: 575-758-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number77238508
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number41281314
License Number StateNM

VIII. Authorized Official

Name: PAMELA GREGORY
Title or Position: CEO
Credential:
Phone: 218-298-0908