1063545671 NPI number — SANTA FE SPEECH SERVICES

Table of content: (NPI 1063545671)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063545671 NPI number — SANTA FE SPEECH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTA FE SPEECH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063545671
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 SAGE HILL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLACITAS
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87043-9426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-660-8308
Provider Business Mailing Address Fax Number:
505-216-9145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 SAGE HILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLACITAS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87043-9426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-660-8308
Provider Business Practice Location Address Fax Number:
505-216-9145
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZAKARY
Authorized Official First Name:
KIRSTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
505-660-8308

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  2820 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: D4566 . This is a "MEDICAID DD WAIVER" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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