Mandy's Special Farm

Primary specialty

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

License

02416649009 Issued in NM

Legal business name

MANDY'S SPECIAL FARM

Doing business as

Mandy's

Practice address

346 Clark Rd SW
Albuquerque, NM 87105-7546

Phone

(505) 873-1187

Fax

(505) 503-6832

NPI assigned

Jan 4, 2011

Last updated

Feb 28, 2012By 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

Ruthie Robbins, JD

Title

President

Phone

(505) 873-1187

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mandy's Doing business as

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1154625275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 CLARK RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871057546",
            "telephone_number": "505-873-1187",
            "fax_number": "505-503-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 CLARK RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871057546",
            "telephone_number": "505-873-1187",
            "fax_number": "505-503-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDY'S SPECIAL FARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "RUTHIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-873-1187",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NM",
            "license": "02416649009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32408382",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mandy's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sreelatha Mandadi, SLP
• Mandala Integrated Therapy LLC
• Soundarya Chowdary Mandava
• Mary Mandeville-Chase
• Teresa Manduchi
• Julie C de Baca Maner, PT
• Alexandra Mang
• Aroop Mangalik
• Akash Mangalore, DO
• Diana Patricia Mangan, RN. MSN.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Albuquerque, NM
• Providers in Albuquerque, 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 Feb 28, 2012; 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.