The Jim Wood Home

NPI 1245629187 - Clinic/Center - 261QC1500X

NPI Details
NPI 1245629187
Enumeration Date 01/15/2015
Last Updated 01/15/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name TRACY TRACY
Position ADMINISTRATOR
Phone (575) 267-1300
Fax
Practice Location
1163 W. CANAL ST.
HATCH NM, 87937-0770, US
Phone (575) 267-1300
Fax
Business Location
PO BOX 770
1163 WEST CANAL ST.
HATCH NM, 87937-0770, US
Phone (575) 267-1300
Fax
Toxanomy
Taxonomy Code 261QC1500X
License State New Mexico
License Number 2261
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According to our database, The Jim Wood Home NPI is 1245629187, taxonomy code is 261QC1500X and license number is 2261, license state is located at New Mexico. The Jim Wood Home physically located at 1163 W. Canal St., Hatch NM, 87937-0770. NPI Number 1033115704 has the healthcare provider type.

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1245629187 NPI number is provided on an as is basis without warranty of any kind. 1245629187 is maintained by the National Plan & Provider Enumeration System. The contents of The Jim Wood Home are for informational purposes only.