Healthcare Provider Details

I. General information

NPI: 1508143652
Provider Name (Legal Business Name): PASOS ADELANTE BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MAGUEY CT STE 1
SUNLAND PARK NM
88063-9513
US

IV. Provider business mailing address

101 MAGUEY CT STE 1
SUNLAND PARK NM
88063-9513
US

V. Phone/Fax

Practice location:
  • Phone: 575-589-2400
  • Fax:
Mailing address:
  • Phone: 575-589-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RUSSELL SCHWEIGER
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 575-915-6700