Healthcare Provider Details

I. General information

NPI: 1679007744
Provider Name (Legal Business Name): EIGHT NORTHERN INDIAN PUEBLOS COUNCIL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 WHITE SWAN RD 327 EAGLE DRIVE
OHKAY OWINGEH NM
87566
US

IV. Provider business mailing address

327 EAGLE DR
OHKAY OWINGEH NM
87566-3600
US

V. Phone/Fax

Practice location:
  • Phone: 505-852-2788
  • Fax:
Mailing address:
  • Phone: 505-852-1377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. TROY CAMPBELL
Title or Position: DIRECTOR OF BEHAVIORAL HEALTH
Credential: LCSW
Phone: 505-852-1377