Healthcare Provider Details

I. General information

NPI: 1255780037
Provider Name (Legal Business Name): BEHAVIORAL HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 SAINT MICHAELS DR STE B204
SANTA FE NM
87505-7681
US

IV. Provider business mailing address

707 BROADWAY BLVD NE STE 500
ALBUQUERQUE NM
87102-2367
US

V. Phone/Fax

Practice location:
  • Phone: 505-268-0701
  • Fax:
Mailing address:
  • Phone: 505-268-0701
  • Fax: 270-689-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ERIC HICK
Title or Position: CFO
Credential:
Phone: 270-689-6540