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General NPI Number Information
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NPI Number | 1942617600
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Entity Type | Organization
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Legal Business Name | EL MIRADOR INCORPORATED
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 10801 LOMAS BLVD NE STE 115
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5474
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Country | US
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Telephone | 505-293-5941
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Fax | 505-271-0484
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Provider Business Mailing Address
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Address Line | 10801 LOMAS BLVD. N.E. SUITE 115
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City | ALBUQUERQUE
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State | NM
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Zip | 87112
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Country | US
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Telephone | 505-271-2280
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOUIS PEREA
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Credential | OWNER
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Telephone | 505-293-5941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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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 | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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