Provider Demographics
NPI:1538515374
Name:FRANCE BORDELEAU LCSW
Entity Type:Organization
Organization Name:FRANCE BORDELEAU LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDELEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-710-8423
Mailing Address - Street 1:10405 CASADOR DEL OSO NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3772
Mailing Address - Country:US
Mailing Address - Phone:505-710-8423
Mailing Address - Fax:505-881-3417
Practice Address - Street 1:10405 CASADOR DEL OSO NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3772
Practice Address - Country:US
Practice Address - Phone:505-710-8423
Practice Address - Fax:505-881-3417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-06163251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM33730300Medicaid