Provider Demographics
NPI:1902798523
Name:THE CARNELIAN CENTER
Entity type:Organization
Organization Name:THE CARNELIAN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-901-1272
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:NM
Mailing Address - Zip Code:87527-0452
Mailing Address - Country:US
Mailing Address - Phone:505-579-9630
Mailing Address - Fax:
Practice Address - Street 1:219 NM STATE RD 75
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:NM
Practice Address - Zip Code:87527
Practice Address - Country:US
Practice Address - Phone:505-579-9630
Practice Address - Fax:505-930-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty