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General NPI Number Information
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NPI Number | 1114161510
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Entity Type | Organization
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Legal Business Name | DULCE INDEPENDENT SCHOOLS
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 125 HAWKS DR
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City | DULCE
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State | NM
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Zip | 87528-0547
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Country | US
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Telephone | 575-759-2924
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Fax | 575-759-1349
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Provider Business Mailing Address
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Address Line | PO BOX 547
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City | DULCE
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State | NM
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Zip | 87528-0547
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Country | US
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Telephone | 575-759-2924
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Fax | 575-759-1349
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Authorized Official
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Title or Position | SUPERINTENDENT OF SCHOOLS
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Name | DR. RALPH FRIEDLY
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Credential |
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Telephone | 575-759-2904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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