Organization
CHARLIE MIKE BASE CAMP
Active
Other names
Charlie Mike, CMBC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES GATES (EXECUTIVE DIRECTOR)
(575) 571-1016
Entity
Organization
Contact information
Practice address
225 E IDAHO AVE STE 27, LAS CRUCES, NM 88005-3242
(575) 571-1016
Mailing address
PO BOX 1676, FAIRACRES, NM 88033-1676
(575) 571-1016
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
332U00000X
Home Delivered Meals
—
—
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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