Provider Demographics
NPI:1104218072
Name:RIO GALLINAS SCHOOL FOR ECOLOGY AND THE ARTS
Entity Type:Organization
Organization Name:RIO GALLINAS SCHOOL FOR ECOLOGY AND THE ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-454-8687
Mailing Address - Street 1:1107 MONTEZUMA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3519
Mailing Address - Country:US
Mailing Address - Phone:505-454-8687
Mailing Address - Fax:
Practice Address - Street 1:1107 MONTEZUMA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3519
Practice Address - Country:US
Practice Address - Phone:505-454-8687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIO GALLINAS SCHOOL FOR ECOLOGY AND THE ARTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)