Organization
SANTA MARIA EL MIRADOR
Active
Other names
Fraternal Order of Knights Templar (FOKT)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELOY F DURAN (DEPUTY DIRECTOR OF FINANCE)
(505) 428-2004
Entity
Organization
Contact information
Practice address
2041 S PACHECO ST, SUITE 100, SANTA FE, NM 87505-5473
(505) 424-7700
(505) 424-7707
Mailing address
2041 S PACHECO ST, SUITE 100, SANTA FE, NM 87505-5473
(505) 424-7700
(505) 424-7707
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
02347611007
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60205512
—
NM
Enumeration date
12/14/2007
Last updated
12/14/2007
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