Provider Demographics
NPI:1831584192
Name:EIGHT NORTHERN INDIAN PUEBLOS COUNCIL, INC.
Entity type:Organization
Organization Name:EIGHT NORTHERN INDIAN PUEBLOS COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GIL
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-231-5469
Mailing Address - Street 1:PO BOX 969
Mailing Address - Street 2:
Mailing Address - City:OHKAY OWINGAY
Mailing Address - State:NM
Mailing Address - Zip Code:87556
Mailing Address - Country:US
Mailing Address - Phone:505-747-1593
Mailing Address - Fax:
Practice Address - Street 1:1130 BUTTERFLY RD.
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:575-751-7688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness