NPIMap

Organization Active NPI

Laguna Early Childhood Program

  • Early Intervention Provider Agency
  • Laguna, NM
National Provider Identifier
1174071534
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
LAGUNA EARLY CHILDHOOD PROGRAM
Practice address
I40 W 114 BLDG 1125
Laguna, NM 87026
Phone
(505) 552-1013
Fax
(505) 552-9569
NPI assigned
Sep 14, 2016
Last updated
Sep 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
June E Boles
Title
Director Division of Early Childhoo
Phone
(505) 552-1013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NM Primary

Addresses

Primary practice location

I40 W 114 BLDG 1125
Laguna, NM 87026

Mailing address

P.O. Box 207
1-40 W Exit 114 BLDG 1125
Laguna, NM 87026
Phone (505) 552-1013

Other identifiers 1

IdentifierTypeStateIssuer
000E7009MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Laguana Department of Education3 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": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1174071534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 207",
            "address_2": "1-40 W EXIT 114 BLDG 1125",
            "city": "LAGUNA",
            "state": "NM",
            "postal_code": "87026",
            "telephone_number": "505-552-1013",
            "fax_number": "505-552-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "I40 W 114 BLDG 1125",
            "city": "LAGUNA",
            "state": "NM",
            "postal_code": "87026",
            "telephone_number": "505-552-1013",
            "fax_number": "505-552-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA EARLY CHILDHOOD PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "BOLES",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR DIVISION OF EARLY CHILDHOO",
        "authorized_official_telephone_number": "505-552-1013"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E7009",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.