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NPI Code Detail

MEDICARE: DANA PAINE ENTERPRISES LLC

MEDICARE: DANA PAINE ENTERPRISES LLC
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 Agency0095841NM

General Provider Information

NPI Number : 1205122769
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANA PAINE ENTERPRISES LLC
Provider Business Mailing Address
First Line : 920 CARDENAS DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1720
Country : US
Telephone Number : 505-266-8168
Fax Number : 505-266-8168
Provider Business Practice Location Address
First Line : 920 CARDENAS DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1720
Country : US
Telephone Number : 505-266-8168
Fax Number : 505-266-8168
Authorized Official
Title or Position : DIRECTOR
Name : DANA JOSEPH PAINE
Credential :
Telephone Number : 505-266-8168
Provider Enumeration Date : 06/23/2011
Last Update Date : 06/04/2026

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Directions to “DANA PAINE ENTERPRISES LLC ” Practice Location

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