1922476084 NPI number — INSIGHT EDUCATIONAL SERVICES

Table of content: (NPI 1922476084)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922476084 NPI number — INSIGHT EDUCATIONAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSIGHT EDUCATIONAL 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:
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:
1922476084
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 CORDOVA PL
Provider Second Line Business Mailing Address:
#402
Provider Business Mailing Address City Name:
SANTA FE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87505-1725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-471-7511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2155 CANDELERO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA FE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87505-5649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-577-7511
Provider Business Practice Location Address Fax Number:
505-473-2812
Provider Enumeration Date:
09/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BAKOS
Authorized Official First Name:
ALEXANDRA
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
505-577-7511

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , with the licence number:  206191 , 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: 206191 . This is a "NMPED" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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