NPI 1073181061

Picuris Pueblo

Organisation Case Management Agency Penasco, NM

Practice location

Address: 201 a Pueblo View Road, Penasco, NM 87553
Phone: (575) 587-2519
Fax: (505) 579-2660
Mailing address: PO Box 127, Penasco, NM 87553

Authorised official

Name: Craig Quanchello
Title: Governor, Picuris Pueblo
Phone: (575) 587-2519

Registered specialties (7)

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Clinical Social Worker

Behavioral Health & Social Service Providers Taxonomy 1041C0700X

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Community Health Worker

Other Service Providers Taxonomy 172V00000X

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Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

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Land Ambulance

Transportation Services Taxonomy 3416L0300X

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Non-emergency Medical Transport (VAN)

Transportation Services Taxonomy 343900000X

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Registry record

NPI: 1073181061
Entity type: Organization
NPI issued: 15 Jun 2021
Record last updated: 26 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.