Tiger Den Wellness Center

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

TIGER DEN WELLNESS CENTER

Practice address

1535 Tiger Circle
Raton, NM 87740

Phone

(575) 445-3641

Fax

(575) 445-8641

NPI assigned

Dec 1, 2009

Last updated

Feb 11, 2016By 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

Dr. James Adrian Abreu

Title

Executive Director

Phone

(505) 454-3523

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Northeast Regional Education Cooperative6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Bernalillo Spartan Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Bernalillo, NM
  • NPI 1861607400
  NPD tax ID
• Northeast Regional Education Cooperative

  • Student Health Clinic/Center
  • Las Vegas, NM
  • NPI 1245597632
  NPD tax ID
• Northeast Regional Education Cooperative

  • Student Health Clinic/Center
  • Bernalillo, NM
  • NPI 1649557521
  NPD tax ID
• Northeast Regional Education Cooperative

  • Student Health Clinic/Center
  • Mora, NM
  • NPI 1932354768
  NPD tax ID
• Santa Rosa Lion Care Health Center

  • Student Health Clinic/Center
  • Santa Rosa, NM
  • NPI 1215213020
  NPD tax ID

Locations

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1962730010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 927",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-426-2262",
            "fax_number": "505-454-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 TIGER CIRCLE",
            "city": "RATON",
            "state": "NM",
            "postal_code": "87740",
            "telephone_number": "575-445-3641",
            "fax_number": "575-445-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIGER DEN WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "ABREU",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-454-3523",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NM",
            "license": "CL00010535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisa Malonzo Tagle, PT
• Marilou Renie Tagliatela, LMSW
• Melanie Tapia, CSW
• Tdcrotinger
• Teambuilders Behavioral Health, LLC
• Jameela Bai Tiku, M.D.
• Omkar Nath Tiku, M.D.
• TKM Corporation (Medicine Shoppe)
• Ryan Trejo
• Susanne Tripodi, D.O.M.

• Student Health Clinic/Center in Raton, NM
• Providers in Raton, NM by specialty
• Student Health Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.