Provider Demographics
NPI:1932241411
Name:TAOS MUNICIPAL CHARTER SCHOOL
Entity type:Organization
Organization Name:TAOS MUNICIPAL CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:O'BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-751-7222
Mailing Address - Street 1:1303 PASEO DEL CANON
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6738
Mailing Address - Country:US
Mailing Address - Phone:505-751-7222
Mailing Address - Fax:505-751-7546
Practice Address - Street 1:1303 PASEO DEL CANON
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6738
Practice Address - Country:US
Practice Address - Phone:505-751-7222
Practice Address - Fax:505-751-7546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM89232780251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM89232780Medicare ID - Type UnspecifiedPUBLIC SCHOOL