Northeast Regional Education Cooperative

Organization Active NPI Student Health Clinic/Center · Mora, NM

NPI 1932354768 · NPPES record last updated Nov 18, 2011

Key facts

NPI
1932354768
Entity type
Organization (NPI type 2)
Primary specialty
Student Health Clinic/Center 261QS1000X
Legal business name
NORTHEAST REGIONAL EDUCATION COOPERATIVE
Practice address
Hwy 518 Ranger Drive
Mora, NM 87732
Phone
(505) 426-2262
Fax
(505) 454-1473
NPI assigned
Nov 20, 2008
Organization subpart
No

Authorized official

Name
Dr. James Adrian Abreu
Title
Executive Director
Phone
(505) 454-3523

Corporate family (same tax ID) 5

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

National Provider Directory

Tax ID family
Northeast Regional Education Cooperative (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Yes

Addresses

Primary practice location

Hwy 518 Ranger Drive
Mora, NM 87732

Mailing address

P.O. Box 927
Las Vegas, NM 87701
Phone (505) 426-2262

Other identifiers

IdentifierTypeStateIssuer
7C01MedicaidNM

Other providers in Mora, NM

All providers in Mora, NM · Student Health Clinic/Center in New Mexico

Sources for this page

Verify at the official NPI Registry.