Provider Demographics
NPI:1861895633
Name:HABITAT FOR HUMANITY OF TAOS, INC.
Entity type:Organization
Organization Name:HABITAT FOR HUMANITY OF TAOS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:ED
Authorized Official - Phone:575-758-7827
Mailing Address - Street 1:PO BOX 1888
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-1888
Mailing Address - Country:US
Mailing Address - Phone:575-758-7827
Mailing Address - Fax:575-758-0715
Practice Address - Street 1:114 ALEXANDER ST
Practice Address - Street 2:SUITE E
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6944
Practice Address - Country:US
Practice Address - Phone:575-758-7827
Practice Address - Fax:575-758-0715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HABITAT FOR HUMANITY INTERNATIONAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM88824251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable