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General NPI Number Information
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NPI Number | 1346722428
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Entity Type | Organization
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Legal Business Name | BEHAVIOR SUPPORT SOLUTIONS
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 9301 INDIAN SCHOOL RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2884
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Country | US
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Telephone | 505-573-2933
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 MOON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2853
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Country | US
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Telephone | 505-573-2933
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONALD HAMILTON
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Credential | LPCC
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Telephone | 505-573-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0167731
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License Number State | NM
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