Provider Demographics
NPI:1366502783
Name:NEW MEXICO SCHOOL FOR THE DEAF STEP HI PROGRAM
Entity Type:Organization
Organization Name:NEW MEXICO SCHOOL FOR THE DEAF STEP HI PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-476-6300
Mailing Address - Street 1:1060 CERRILLOS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1650
Mailing Address - Country:US
Mailing Address - Phone:505-476-6300
Mailing Address - Fax:
Practice Address - Street 1:1060 CERRILLOS RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1650
Practice Address - Country:US
Practice Address - Phone:505-476-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM01505868009251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM61380539Medicaid