Provider Demographics
NPI:1114161510
Name:DULCE INDEPENDENT SCHOOLS
Entity Type:Organization
Organization Name:DULCE INDEPENDENT SCHOOLS
Other - Org Name:DULCE TEEN HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-759-2904
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:DULCE
Mailing Address - State:NM
Mailing Address - Zip Code:87528-0547
Mailing Address - Country:US
Mailing Address - Phone:575-759-2924
Mailing Address - Fax:575-759-1349
Practice Address - Street 1:125 HAWKS DR
Practice Address - Street 2:
Practice Address - City:DULCE
Practice Address - State:NM
Practice Address - Zip Code:87528-0547
Practice Address - Country:US
Practice Address - Phone:575-759-2924
Practice Address - Fax:575-759-1349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health