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Organization
NEW MEXICO WIC PROGRAM
Active
Organization
NEW MEXICO WIC PROGRAM
Active
Parent organization
STATE OF NEW MEXICO
Other names
New Mexico WIC Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW MEXICO
Authorized official
MICHELLE D CISNEROS (MEDICAID MANAGED CARE CONTRACTS)
(505) 623-1256
Entity
Organization
Contact information
Practice address
2040 S PACHECO ST, SANTA FE, NM 87505-5472
(505) 476-8800
(505) 476-8900
Mailing address
2040 S PACHECO ST, SANTA FE, NM 87505-5472
(505) 476-8800
(505) 476-8900
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
07/23/2026
Last updated
07/30/2026
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