Organization
MORENO VALLEY HIGH SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILIANN WILLIAMS (BUSINESS MANAGER)
(575) 377-3100
Entity
Organization
Contact information
Practice address
56 CAMINO GRANDE, ANGEL FIRE, NM 87710-8771
(575) 377-3100
(575) 377-3100
Mailing address
PO BOX 1037, ANGEL FIRE, NM 87710-1037
(575) 377-3100
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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