Provider Demographics
NPI:1134968944
Name:NORTH CENTRAL NEW MEXICO ECONOMIC DEVELOPMENT DISTRICT
Entity type:Organization
Organization Name:NORTH CENTRAL NEW MEXICO ECONOMIC DEVELOPMENT DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROJECTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-787-3774
Mailing Address - Street 1:644 DON GASPAR AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2666
Mailing Address - Country:US
Mailing Address - Phone:505-787-3774
Mailing Address - Fax:
Practice Address - Street 1:644 DON GASPAR AVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2666
Practice Address - Country:US
Practice Address - Phone:505-787-3774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management