NPI 1609318112

Roots & Wings Community Charter School

Organisation Exclusive Provider Organization Albuquerque, NM

Practice location

Address: 35 La Lama Road, Albuquerque, NM 87556
Phone: (575) 585-2076
Fax: (575) 586-2087
Mailing address: Hc 81, P.O. Box 22 35 La Lama Road, Albuquerque, NM 87556

Authorised official

Name: Charlotte M Archuleta
Title: Business Manager/Cpo
Phone: (505) 450-1415

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 000T6366 (NM)

Other Exclusive Provider Organization providers in New Mexico →

Registry record

NPI: 1609318112
Entity type: Organization
NPI issued: 15 Nov 2016
Record last updated: 15 Nov 2016

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.