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General NPI Number Information
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NPI Number | 1003096264
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Entity Type | Organization
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Legal Business Name | SANGRE DE CRISTO COMMUNITY HEALTH PARTNERSHIP
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 1441 S SAINT FRANCIS DR
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City | SANTA FE
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State | NM
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Zip | 87505-4037
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Country | US
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Telephone | 505-982-8870
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Fax | 505-982-4480
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Provider Business Mailing Address
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Address Line | 1441 S SAINT FRANCIS DR
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City | SANTA FE
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State | NM
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Zip | 87505-4037
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Country | US
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Telephone | 505-982-8870
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Fax | 505-982-4480
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ARTURO N GONZALES
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Credential | PH.D
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Telephone | 505-982-8870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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