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General NPI Number Information
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NPI Number | 1588794259
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Entity Type | Organization
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Legal Business Name | DULCE INDEPENDENT SCHOOL DISTRICT
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 113 HAWK DRIVE
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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 | 505-759-2913
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Fax |
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Provider Business Mailing Address
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Address Line | 113 HAWK DRIVE 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 | 505-759-2951
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Fax |
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Authorized Official
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Title or Position | MEDICAID COORDINATOR
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Name | MS. RAMONA LUCERO
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Credential |
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Telephone | 505-759-2954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 01-600729-00-8
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License Number State | NM
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