Organization
ROOTS & WINGS COMMUNITY CHARTER SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE M ARCHULETA (BUSINESS MANAGER/CPO)
(505) 450-1415
Entity
Organization
Contact information
Practice address
35 LA LAMA ROAD, ALBUQUERQUE, NM 87556
(575) 585-2076
(575) 586-2087
Mailing address
HC 81, P.O. BOX 22, 35 LA LAMA ROAD, ALBUQUERQUE, NM 87556
(575) 585-2076
(575) 586-2087
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
000T6366
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376509448
—
NM
Enumeration date
11/15/2016
Last updated
11/15/2016
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