Provider Demographics
NPI:1497007132
Name:MCCURDY CHARTER SCHOOL
Entity Type:Organization
Organization Name:MCCURDY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHULETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-753-7221
Mailing Address - Street 1:PO BOX 2250
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2250
Mailing Address - Country:US
Mailing Address - Phone:505-753-7221
Mailing Address - Fax:505-753-0192
Practice Address - Street 1:341 S. MCCURDY RD.
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532
Practice Address - Country:US
Practice Address - Phone:505-753-7221
Practice Address - Fax:505-753-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM43989331Medicaid