Provider Demographics
NPI:1770877961
Name:GR8EXPECTATIONS
Entity type:Organization
Organization Name:GR8EXPECTATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ZARING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-261-9925
Mailing Address - Street 1:83 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-0786
Mailing Address - Country:US
Mailing Address - Phone:505-261-9925
Mailing Address - Fax:
Practice Address - Street 1:83 2ND ST SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-0786
Practice Address - Country:US
Practice Address - Phone:505-261-9925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251S00000X320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities