Provider Demographics
NPI:1477683316
Name:COBRE CONSOLIDATED SCHOOLS
Entity Type:Organization
Organization Name:COBRE CONSOLIDATED SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-537-4000
Mailing Address - Street 1:900 CENTRAL
Mailing Address - Street 2:
Mailing Address - City:BAYARD
Mailing Address - State:NM
Mailing Address - Zip Code:88023
Mailing Address - Country:US
Mailing Address - Phone:505-537-4000
Mailing Address - Fax:505-537-3921
Practice Address - Street 1:900 CENTRAL
Practice Address - Street 2:
Practice Address - City:BAYARD
Practice Address - State:NM
Practice Address - Zip Code:88023
Practice Address - Country:US
Practice Address - Phone:505-537-4000
Practice Address - Fax:505-537-3921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000L1871Medicaid