Healthcare Provider Details

I. General information

NPI: 1154272383
Provider Name (Legal Business Name): CYTI HEALTH PROVIDERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MOUNTAIN ROAD PL NE STE N
ALBUQUERQUE NM
87110-7845
US

IV. Provider business mailing address

1930 VILLAGE CENTER CIR # 3-317
LAS VEGAS NV
89134-6299
US

V. Phone/Fax

Practice location:
  • Phone: 866-478-3978
  • Fax: 866-473-0365
Mailing address:
  • Phone: 866-478-3978
  • Fax: 866-473-0365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DANIEL J. COSTA
Title or Position: OWNER
Credential:
Phone: 866-478-3978