Organization
SANTA MARIA EL MIRADOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ROMERO (CEO)
(505) 424-7700
Entity
Organization
Contact information
Practice address
10 A VAN NU PO, SANTA FE, NM 87508
(505) 424-7700
(505) 395-7452
Mailing address
10 A VAN NU PO, SANTA FE, NM 87508
(505) 424-7700
(505) 395-7452
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0974
DD WAIVER
NM
05
—
M1202
—
NM
05
—
M1451
—
NM
05
—
M1995
—
NM
05
—
M2343
—
NM
05
—
M2431
—
NM
Enumeration date
03/07/2007
Last updated
07/22/2023
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