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General NPI Number Information
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NPI Number | 1467753954
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Entity Type | Organization
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Legal Business Name | SUBSTANCE ABUSE & MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 108 SERVICE RD
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City | RUIDOSO
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State | NM
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Zip | 88345-6045
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Country | US
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Telephone | 575-257-8942
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Fax | 575-257-8943
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Provider Business Mailing Address
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Address Line | 108 SERVICE RD
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City | RUIDOSO
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State | NM
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Zip | 88345-6045
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Country | US
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Telephone | 575-257-8942
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Fax | 575-257-8943
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. GARY GARLAND
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Credential | LADAC,CS CFAE
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Telephone | 575-257-8942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 006181
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License Number State | NM
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