Healthcare Provider Details

I. General information

NPI: 1376606186
Provider Name (Legal Business Name): YOUTH & FAMILY CENTERED SERVICES OF NM, INC DBA DESERT HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 SEQUOIA RD NW
ALBUQUERQUE NM
87120-1249
US

IV. Provider business mailing address

5310 SEQUOIA RD NW
ALBUQUERQUE NM
87120-1249
US

V. Phone/Fax

Practice location:
  • Phone: 505-836-7330
  • Fax: 505-836-7424
Mailing address:
  • Phone: 505-836-7330
  • Fax: 505-836-7424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number1014A,4406,
License Number StateNM

VIII. Authorized Official

Name: MISS CAROL BICKELMAN
Title or Position: CEO
Credential: LPCC
Phone: 505-836-7330