MEDICARE: BEHAVIORAL HEALTHCARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1255780037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	707 BROADWAY BLVD NE STE 500
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2367
Country	:	US
Telephone Number	:	505-268-0701
Fax Number	:	270-689-6677

Provider Business Practice Location Address
First Line	:	435 SAINT MICHAELS DR STE B204
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-7681
Country	:	US
Telephone Number	:	505-268-0701
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ERIC HICK
Credential	:
Telephone Number	:	270-689-6540

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	07/02/2024

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