Organization
NORTHEAST REGIONAL EDUCATION COOPERATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ADRIAN ABREU (EXECUTIVE DIRECTOR)
(505) 454-3523
Entity
Organization
Contact information
Practice address
HWY 518 RANGER DRIVE, MORA, NM 87732
(505) 426-2262
(505) 454-1473
Mailing address
P.O. BOX 927, LAS VEGAS, NM 87701
(505) 426-2262
(505) 454-1473
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7C01
—
NM
Enumeration date
11/20/2008
Last updated
11/18/2011
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