Provider Demographics
NPI:1306179692
Name:ALEJANDRA TAYPE-MIRANDA
Entity Type:Organization
Organization Name:ALEJANDRA TAYPE-MIRANDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYPE-MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-212-7467
Mailing Address - Street 1:632 CHAMA ST SE
Mailing Address - Street 2:APT A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-3963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:632 CHAMA ST SE
Practice Address - Street 2:APT A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-3963
Practice Address - Country:US
Practice Address - Phone:505-212-7467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUTH DEVELOPMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management