NPIMap

Organization Active NPI

Youth Shelters

  • Social Worker
  • Santa Fe, NM
National Provider Identifier
1003140658
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M06966 Issued in NM
Legal business name
YOUTH SHELTERS
Practice address
5686 Agua Fria St
Santa Fe, NM 87507-9001
Phone
(505) 438-0502
Fax
(505) 438-0504
NPI assigned
Sep 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Toni Kuehn
Title
Program Director Shelter
Phone
(505) 438-0502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X M06966 NM Primary

Addresses

Primary practice location

5686 Agua Fria St
Santa Fe, NM 87507-9001

Mailing address

5686 Agua Fria St
Santa Fe, NM 87507-9001

Other identifiers 1

IdentifierTypeStateIssuer
104100000XMedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Youth Shelters3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1003140658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5686 AGUA FRIA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875079001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5686 AGUA FRIA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875079001",
            "telephone_number": "505-438-0502",
            "fax_number": "505-438-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SHELTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "KUEHN",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR SHELTER",
        "authorized_official_telephone_number": "505-438-0502"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M06966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104100000X",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.