MEDICARE: HIGH DESERT FAMILY SERVICES, INC.

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
1	253J00000X	Foster Care Agency	0000113197	NM
2	101YM0800X	Mental Health Counselor		NM
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1851434138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH DESERT FAMILY SERVICES, INC.

Provider Business Mailing Address
First Line	:	7001 PROSPECT PL NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4311
Country	:	US
Telephone Number	:	505-823-4530
Fax Number	:	505-797-3956

Provider Business Practice Location Address
First Line	:	7001 PROSPECT PL NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4311
Country	:	US
Telephone Number	:	505-823-4530
Fax Number	:	505-797-3956

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR, CEO
Name	:	MR. CARL DENNIS JAMES
Credential	:
Telephone Number	:	505-823-4530

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	01/17/2014

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Directions to “HIGH DESERT FAMILY SERVICES, INC. ” Practice Location

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