Healthcare Provider Details
I. General information
NPI: 1467310185
Provider Name (Legal Business Name): IRIS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7704 SAN FRANCISQUITA CT NW
ALBUQUERQUE NM
87120-3653
US
IV. Provider business mailing address
6300 RIVERSIDE PLAZA LN NW STE 118
ALBUQUERQUE NM
87120-2617
US
V. Phone/Fax
- Phone: 505-226-1594
- Fax:
- Phone: 505-226-1594
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMANTHA
OLIVAS
Title or Position: OWNER
Credential: BCBA
Phone: 505-226-1594