Healthcare Provider Details

I. General information

NPI: 1932043387
Provider Name (Legal Business Name): VANGUARD BEHAVIORAL HEALTH SF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 RODEO RD
SANTA FE NM
87507-4830
US

IV. Provider business mailing address

4001 RODEO RD
SANTA FE NM
87507-4830
US

V. Phone/Fax

Practice location:
  • Phone: 866-425-1912
  • Fax:
Mailing address:
  • Phone: 866-425-1912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER WORNICK
Title or Position: CEO
Credential:
Phone: 214-315-0933