Provider Demographics
NPI:1043773849
Name:FLORES BILINGUAL SPEECH & LANGUAGE SERVICES INC
Entity Type:Organization
Organization Name:FLORES BILINGUAL SPEECH & LANGUAGE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NENY
Authorized Official - Middle Name:IVONNE
Authorized Official - Last Name:FLORES -GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:505-306-1532
Mailing Address - Street 1:11501 WOODMAR LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-6516
Mailing Address - Country:US
Mailing Address - Phone:505-306-1532
Mailing Address - Fax:505-508-4353
Practice Address - Street 1:11501 WOODMAR LN NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-6516
Practice Address - Country:US
Practice Address - Phone:505-306-1532
Practice Address - Fax:505-508-4353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM12507202Medicaid