Provider Demographics
NPI:1992253355
Name:TOBOSA DEVELOPMENTAL SERVICES, INC.
Entity type:Organization
Organization Name:TOBOSA DEVELOPMENTAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-624-1025
Mailing Address - Street 1:110 E SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-5619
Mailing Address - Country:US
Mailing Address - Phone:575-624-1025
Mailing Address - Fax:
Practice Address - Street 1:110 E SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-5619
Practice Address - Country:US
Practice Address - Phone:575-624-1025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency