Provider Demographics
NPI:1942617600
Name:EL MIRADOR INCORPORATED
Entity type:Organization
Organization Name:EL MIRADOR INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:505-293-5941
Mailing Address - Street 1:10801 LOMAS BLVD. N.E.
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112
Mailing Address - Country:US
Mailing Address - Phone:505-271-2280
Mailing Address - Fax:
Practice Address - Street 1:10801 LOMAS BLVD NE STE 115
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5474
Practice Address - Country:US
Practice Address - Phone:505-293-5941
Practice Address - Fax:505-271-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty