Provider Demographics
NPI:1801021670
Name:COMMUNTIY ACTION AGENCY OF SOUTHERN N.M., INC.
Entity Type:Organization
Organization Name:COMMUNTIY ACTION AGENCY OF SOUTHERN N.M., INC.
Other - Org Name:GADSDEN MIDDLE SCHOOL, SCHOOL BASED HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-527-8799
Mailing Address - Street 1:3880 FOOTHILLS RD.
Mailing Address - Street 2:SUITE A.
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011
Mailing Address - Country:US
Mailing Address - Phone:575-527-8799
Mailing Address - Fax:575-527-9028
Practice Address - Street 1:3880 FOOTHILLS RD.
Practice Address - Street 2:SUITE A.
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:575-527-8799
Practice Address - Fax:575-527-9028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251K00000XAgenciesPublic Health or Welfare