MEDICARE: NAVA BEHAVIORAL HEALTH LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1871336271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVA BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 1078
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88004-1078
Country	:	US
Telephone Number	:	575-205-4029
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 N SOLANO DR STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-2366
Country	:	US
Telephone Number	:	575-205-4029
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LEE KING
Credential	:
Telephone Number	:	575-205-4029

Provider Enumeration Date	:	06/14/2024
Last Update Date	:	06/14/2024

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