Organization
ENMU-ROSWELL SCHOOL BASED HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENEVA JEWEL DEARING CMA (HEALTH COORDINATOR)
(505) 627-2808
Entity
Organization
Contact information
Practice address
1601 E BLAND ST, ROSWELL, NM 88203-7900
(505) 627-2808
(505) 624-2290
Mailing address
PO BOX 6000, ATTN JANE BATSON SBHC, ROSWELL, NM 88202-6000
(505) 627-2808
(505) 624-2290
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9A01
—
NM
Enumeration date
01/25/2007
Last updated
09/13/2011
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