Healthcare Provider Details

I. General information

NPI: 1205607314
Provider Name (Legal Business Name): C&J BEHAVIORAL HEALTH CONSULTATIONS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 DELEDDA RD NE
RIO RANCHO NM
87144-0609
US

IV. Provider business mailing address

3520 DELEDDA RD NE
RIO RANCHO NM
87144-0609
US

V. Phone/Fax

Practice location:
  • Phone: 210-857-4200
  • Fax:
Mailing address:
  • Phone: 210-857-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN G SANCHEZ
Title or Position: OWNER
Credential: LCSW
Phone: 210-857-4200