Provider Demographics
NPI:1811212004
Name:RATON MUNICIPAL SCHOOL DISTRICT #11
Entity Type:Organization
Organization Name:RATON MUNICIPAL SCHOOL DISTRICT #11
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BASED HEALTH CENTER COOR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-445-3541
Mailing Address - Street 1:1535 TIGER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:RATON
Mailing Address - State:NM
Mailing Address - Zip Code:87740
Mailing Address - Country:US
Mailing Address - Phone:575-445-9111
Mailing Address - Fax:
Practice Address - Street 1:1535 TIGER CIRCLE
Practice Address - Street 2:
Practice Address - City:RATON
Practice Address - State:NM
Practice Address - Zip Code:87740
Practice Address - Country:US
Practice Address - Phone:575-445-3541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)