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NPI Code Detail

MEDICARE: CARINO FAMILY SERVICES INC

MEDICARE: CARINO FAMILY SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency4780310NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093149056
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARINO FAMILY SERVICES INC
Provider Business Mailing Address
First Line : PO BOX 84
Second Line :
City : MORA
State : NM
Zip : 87732-0084
Country : US
Telephone Number : 575-520-9899
Fax Number :
Provider Business Practice Location Address
First Line : 2528 RIDGE RUNNER RD
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4971
Country : US
Telephone Number : 575-520-9899
Fax Number : 505-425-9223
Authorized Official
Title or Position : PRESIDENT & CEO
Name : BREENA TAFOYA
Credential : LISW
Telephone Number : 575-520-9899
Provider Enumeration Date : 08/27/2013
Last Update Date : 04/14/2014

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