Organization
RANCHO RIOS DOMINGUEZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSIE JOANNE RIOS CBEIP (INSTRUCTOR COACH)
(575) 621-5913
Entity
Organization
Contact information
Practice address
230 EL PESCADO RD, CHAMBERINO, NM 88027-9005
(575) 621-5913
Mailing address
PO BOX 163, CHAMBERINO, NM 88027-0163
(575) 621-5913
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/04/2025
Last updated
10/04/2025
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