MEDICARE: TRU-QUALITY DESIGN/CONSTRUCTION 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
1	225XE0001X	Environmental Modification Occupational Therapist	381909	NM

Other Identifiers

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

General Provider Information

NPI Number	:	1366801862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRU-QUALITY DESIGN/CONSTRUCTION INC.

Provider Business Mailing Address
First Line	:	3301 COORS BLVD NW STE R
Second Line	:	158
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-1268
Country	:	US
Telephone Number	:	505-459-3231
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 MESQUITE WOOD DR NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-4047
Country	:	US
Telephone Number	:	505-459-3231
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL ORTIZ
Credential	:
Telephone Number	:	505-459-3231

Provider Enumeration Date	:	02/12/2016
Last Update Date	:	02/12/2016

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