Provider Demographics
NPI:1922195544
Name:REGION IX EDUCATION COOPERATIVE
Entity Type:Organization
Organization Name:REGION IX EDUCATION COOPERATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID SERVICES TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-257-2368
Mailing Address - Street 1:237 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6063
Mailing Address - Country:US
Mailing Address - Phone:505-257-2368
Mailing Address - Fax:505-257-2141
Practice Address - Street 1:237 SERVICE RD
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6063
Practice Address - Country:US
Practice Address - Phone:505-257-2368
Practice Address - Fax:505-257-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
E7676OtherREGION IX EDUCATION COOP
NM=========Medicaid