Healthcare Provider Details

I. General information

NPI: 1720269848
Provider Name (Legal Business Name): MENTAL HEALTH SERVICES OF DONA ANA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 DEL REY BLVD
LAS CRUCES NM
88012-7710
US

IV. Provider business mailing address

840 N TELSHOR BLVD STE A
LAS CRUCES NM
88011-8205
US

V. Phone/Fax

Practice location:
  • Phone: 575-649-6882
  • Fax: 575-373-4879
Mailing address:
  • Phone: 575-649-6882
  • Fax: 575-373-4879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberR15936
License Number StateNM

VIII. Authorized Official

Name: FRANCES E GLASSCOCK
Title or Position: OWNER
Credential: MSN RN CS
Phone: 575-649-6882