Healthcare Provider Details

I. General information

NPI: 1255210167
Provider Name (Legal Business Name): TURQUOISE FAMILY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CANYON LN
CEDAR CREST NM
87008-9458
US

IV. Provider business mailing address

PO BOX 845
CEDAR CREST NM
87008-0845
US

V. Phone/Fax

Practice location:
  • Phone: 575-621-0144
  • Fax:
Mailing address:
  • Phone: 575-621-0144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATALIE TAVITAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-575-0704