Provider Demographics
NPI:1265690341
Name:ACORNS TO OAKS
Entity Type:Organization
Organization Name:ACORNS TO OAKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-332-2402
Mailing Address - Street 1:PO BOX 16655
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87191-6655
Mailing Address - Country:US
Mailing Address - Phone:505-332-2402
Mailing Address - Fax:
Practice Address - Street 1:5345 WYOMING BLVD NE
Practice Address - Street 2:SUITE 105
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3148
Practice Address - Country:US
Practice Address - Phone:505-332-2402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000A1361OtherPROVIDER NUMBER
NM67205330OtherPROVIDER NUMBER