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NPI Code Detail

MEDICARE: NEW MEXICO BEHAVIORAL HEALTH INSTITUTE

MEDICARE: NEW MEXICO BEHAVIORAL HEALTH INSTITUTE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care Facility5067NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114916319
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW MEXICO BEHAVIORAL HEALTH INSTITUTE
Provider Business Mailing Address
First Line : 3695 HOT SPRINGS BLVD
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-9549
Country : US
Telephone Number : 505-454-2190
Fax Number : 505-454-2222
Provider Business Practice Location Address
First Line : 3695 HOT SPRINGS BLVD
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-9549
Country : US
Telephone Number : 505-454-2190
Fax Number : 505-454-2222
Authorized Official
Title or Position : NURSING HOME ADMINISTRATOR
Name : MR. WILLIAM CHALTRY
Credential : NHA
Telephone Number : 505-454-2190
Provider Enumeration Date : 10/19/2005
Last Update Date : 08/22/2020

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Directions to “NEW MEXICO BEHAVIORAL HEALTH INSTITUTE ” Practice Location

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