Sorinity Support Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SORINITY SUPPORT SERVICES, LLC

Practice address

818 W Granada St
Espanola, NM 87532-2409

Phone

(505) 629-1712

Fax

(877) 712-4623

NPI assigned

Jun 21, 2016

Last updated

Jun 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alvina Roberts

Title

Executive Director

Phone

(505) 629-1712

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1033569074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 LANG AVE NE",
            "address_2": "SUITE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094474",
            "telephone_number": "505-629-1712",
            "fax_number": "877-712-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W GRANADA ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322409",
            "telephone_number": "505-629-1712",
            "fax_number": "877-712-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SORINITY SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ALVINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-629-1712"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009302900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Simpson
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• Laurel Anne Stevens, CFNP
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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Espanola, NM
• Providers in Espanola, NM by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.