Organization
CHARLIE MIKE BASE CAMP
Active
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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