Healthcare Provider Details

I. General information

NPI: 1184438665
Provider Name (Legal Business Name): HIGH PLAINS PSYCHIATRIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
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

1650 FILLMORE ST APT 1006
DENVER CO
80206-1590
US

V. Phone/Fax

Practice location:
  • Phone: 719-966-0534
  • Fax:
Mailing address:
  • Phone: 832-638-8872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JUDY KANTA PATE
Title or Position: AO
Credential:
Phone: 832-638-8872