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General NPI Number Information
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NPI Number | 1710645494
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Entity Type | Organization
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Legal Business Name | WAVES BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 7510 MONTGOMERY BLVD NE STE 202
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1500
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Country | US
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Telephone | 505-933-1978
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Fax |
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Provider Business Mailing Address
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Address Line | 7510 MONTGOMERY BLVD NE STE 202
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1500
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Country | US
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Telephone | 505-933-1978
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA SMITH
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Credential |
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Telephone | 505-596-0254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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