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General NPI Number Information
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NPI Number | 1497007132
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Entity Type | Organization
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Legal Business Name | MCCURDY CHARTER SCHOOL
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 341 S. MCCURDY RD.
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City | ESPANOLA
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State | NM
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Zip | 87532
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Country | US
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Telephone | 505-753-7221
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Fax | 505-753-0192
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Provider Business Mailing Address
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Address Line | PO BOX 2250
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City | ESPANOLA
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State | NM
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Zip | 87532-2250
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Country | US
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Telephone | 505-753-7221
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Fax | 505-753-0192
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JANETTE ARCHULETA
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Credential |
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Telephone | 505-753-7221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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