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General NPI Number Information
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NPI Number | 1073245312
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Entity Type | Organization
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Legal Business Name | EL CALVARIO UNITED METHODIST CHURCH
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 300 N CAMPO ST
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City | LAS CRUCES
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State | NM
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Zip | 88001-3433
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Country | US
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Telephone | 575-524-1230
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2842
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City | LAS CRUCES
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State | NM
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Zip | 88004-2842
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Country | US
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Telephone | 360-674-9822
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GEORGE A MILLER
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Credential | REV
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Telephone | 360-674-9822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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