Healthcare Provider Details

I. General information

NPI: 1548113293
Provider Name (Legal Business Name): COTTONWOOD BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PINETREE RD SE # 15367
RIO RANCHO NM
87124-7615
US

IV. Provider business mailing address

900 PINETREE RD SE # 15367
RIO RANCHO NM
87124-7615
US

V. Phone/Fax

Practice location:
  • Phone: 505-353-7926
  • Fax:
Mailing address:
  • Phone: 505-353-7926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: PAIGE ROSE BENNETT
Title or Position: OWNER
Credential: LMHC, LAMFT, LADAC
Phone: 505-353-7926