Provider Demographics
NPI:1861668287
Name:JARDIN DE LOS NINOS
Entity type:Organization
Organization Name:JARDIN DE LOS NINOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-522-2111
Mailing Address - Street 1:1300 EL PASEO RD STE G
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-6039
Mailing Address - Country:US
Mailing Address - Phone:575-522-2111
Mailing Address - Fax:575-522-3595
Practice Address - Street 1:1300 G EL PASEO #272
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-6024
Practice Address - Country:US
Practice Address - Phone:575-522-2111
Practice Address - Fax:575-522-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health