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General NPI Number Information
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NPI Number | 1639957517
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Entity Type | Organization
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Legal Business Name | CONSORTIUM CARE OF NEW MEXICO, LLC
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 5203 JUAN TABO BLVD NE STE 2A
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2691
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Country | US
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Telephone | 301-525-3933
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Fax | 800-521-9231
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Provider Business Mailing Address
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Address Line | 5203 JUAN TABO BLVD NE STE 2A
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2691
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Country | US
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Telephone | 301-525-3933
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Fax | 800-521-9231
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Authorized Official
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Title or Position | CEO
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Name | CLAUDIA WARREN-TAYLOR
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Credential | DNP
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Telephone | 301-525-3933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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