Provider Demographics
NPI:1770624348
Name:POSITIVE OUTCOMES, INC.
Entity type:Organization
Organization Name:POSITIVE OUTCOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MA- CCC- SLP
Authorized Official - Phone:505-838-0800
Mailing Address - Street 1:PO BOX 642
Mailing Address - Street 2:1115 NORTH CALIFORNIA STREET
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-0642
Mailing Address - Country:US
Mailing Address - Phone:505-838-0800
Mailing Address - Fax:505-838-3999
Practice Address - Street 1:1115 NORTH CALIFORNIA STREET
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-0642
Practice Address - Country:US
Practice Address - Phone:505-838-0800
Practice Address - Fax:505-838-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103TC2200X, 225100000X, 225X00000X, 3747P1801X
NM171WH0202X, 385HR2065X
NM006549235Z00000X
NM1487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, ChildGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM88722520Medicaid
NM800521047Medicaid
NM00P3051Medicaid
NM69676577Medicaid
NMD4005Medicaid
NM88722520Medicaid