Dungarvin New Mexico, LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Gallup, NM
NPI 1871200477 · NPPES record last updated Apr 27, 2023
Key facts
- NPI
- 1871200477
- 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
- 513B Williams St
Gallup, NM 87301-4799 - Phone
- (505) 722-4383
- 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
National Provider Directory
- Tax ID family
- Dungarvin New Mexico LLC
Locations
513B Williams St
Gallup, NM 87301
Phone (505) 722-4383
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
513B Williams St
Gallup, NM 87301-4799
Mailing address
1444 Northland Dr Ste 200
Mendota Heights, MN 55120-1032
Phone (651) 789-5968
Other providers in Gallup, NM
- Darrel Dryden
- Mufaro Dube
- Tiffany Dubos
- Uma D Duggirala
- Xolani Dumani
- Susan O. Dunham
- Dixie K. Dunn
- Candace J Duran
- Lorayne Durham
- Mary Grace Uy Dy
All providers in Gallup, NM · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.