NPIMap

Organization Active NPI

Dungarvin New Mexico LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Farmington, NM
National Provider Identifier
1508573106
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DUNGARVIN NEW MEXICO LLC
Practice address
614 Dekalb Rd
Farmington, NM 87401-1600
Phone
(505) 436-2245
NPI assigned
Nov 2, 2022
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DUNGARVIN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

614 Dekalb Rd
Farmington, NM 87401-1600

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Dungarvin New Mexico LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

614 DeKalb Rd
Farmington, NM 87401
Phone (505) 436-2245

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1508573106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 NORTHLAND DR STE 200",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201032",
            "telephone_number": "651-789-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 DEKALB RD",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874011600",
            "telephone_number": "505-436-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNGARVIN NEW MEXICO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNGARVIN GROUP, INC.",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "KRESS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-699-0206"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.