Provider Demographics
NPI:1861412777
Name:ALAMO NAVAJO SCHOOL BOARD, INC.
Entity type:Organization
Organization Name:ALAMO NAVAJO SCHOOL BOARD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES DIRE
Authorized Official - Prefix:MS
Authorized Official - First Name:CLORA
Authorized Official - Middle Name:PHYLLIS
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:575-854-2626
Mailing Address - Street 1:PO BOX 5907
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:NM
Mailing Address - Zip Code:87825
Mailing Address - Country:US
Mailing Address - Phone:575-854-2626
Mailing Address - Fax:575-854-2528
Practice Address - Street 1:MILEPOST 29, HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:NM
Practice Address - Zip Code:87825
Practice Address - Country:US
Practice Address - Phone:575-854-2626
Practice Address - Fax:575-854-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMJ6136261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMJ6136Medicaid
NMB5467OtherNM DRUG NUMBER
NM3210298OtherNABP NUMBER
NMB5467OtherNM DRUG NUMBER
NM3210298OtherNABP NUMBER
NMAA2484931OtherDEA REG. NUMBER