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Dungarvin New Mexico, LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Grants, NM

NPI 1033826631 · NPPES record last updated Apr 27, 2023

Key facts

NPI
1033826631
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
DUNGARVIN NEW MEXICO, LLC
Practice address
825 E Roosevelt Ave
Grants, NM 87020-2115
Phone
(505) 287-9209
NPI assigned
Nov 2, 2022
Organization subpart
Yes
Parent organization (as reported)
DUNGARVIN GROUP, INC.

Authorized official

Name
Lori Kress
Title
Ceo
Phone
(651) 699-0206

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Dungarvin New Mexico LLC (4 organizations share this tax ID)

Locations

825 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-2450

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

825 E Roosevelt Ave
Grants, NM 87020-2115

Mailing address

1444 Northland Dr Ste 200
Mendota Heights, MN 55120-1032
Phone (651) 789-5968

Other providers in Grants, NM

All providers in Grants, NM · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Mexico

Sources for this page

Verify at the official NPI Registry.