Healthcare Provider Details

I. General information

NPI: 1124238266
Provider Name (Legal Business Name): MESILLA VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 SENECA DR
LAS CRUCES NM
88005-0818
US

IV. Provider business mailing address

4115 SENECA DR
LAS CRUCES NM
88005-0818
US

V. Phone/Fax

Practice location:
  • Phone: 505-202-2014
  • Fax:
Mailing address:
  • Phone: 505-202-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberI-06500
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberI-06500
License Number StateNM

VIII. Authorized Official

Name: ADRIANNE TERESSA AGUILERA
Title or Position: MST SUPERVISOR
Credential: LISW
Phone: 505-202-2014