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Organization
SANTA MARIA EL MIRADOR
Active
Organization
SANTA MARIA EL MIRADOR
Active
Other names
Fraternal Order of Knights Templar (FOKT)
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ROMERO (CEO)
(505) 424-7700
Entity
Organization
Contact information
Practice address
10 A VAN NU PO, SANTA FE, NM 87508
(505) 424-7700
(505) 395-7452
Mailing address
10 A VAN NU PO, SANTA FE, NM 87508
(505) 424-7700
(505) 395-7452
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M1468
—
NM
05
—
M2296
—
NM
05
—
M2395
—
NM
Enumeration date
05/11/2007
Last updated
07/22/2023
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