# NEW MEXICO WIC PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE OF NEW MEXICO
- **Other names:** New Mexico WIC Program
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376464594
- **Legal business name:** STATE OF NEW MEXICO
- **Authorized official:** MICHELLE D CISNEROS (MEDICAID MANAGED CARE CONTRACTS)
- **Authorized official phone:** (505) 623-1256

## Contact information

- **Practice address:** 2040 S PACHECO ST, SANTA FE, NM 87505-5472
- **Practice address phone:** (505) 476-8800
- **Practice address fax:** (505) 476-8900
- **Mailing address:** 2040 S PACHECO ST, SANTA FE, NM 87505-5472
- **Mailing address phone:** (505) 476-8800
- **Mailing address fax:** (505) 476-8900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/23/2026
- **Last updated:** 07/30/2026