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Organization
SAGE CHILD AND ADOLESCENT SERVICES
Active
Organization
SAGE CHILD AND ADOLESCENT SERVICES
Active
Parent organization
SAGE NEUROSCIENCE CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAGE NEUROSCIENCE CENTER INC
Authorized official
DR. REUBEN SUTTER MD (CEO)
(505) 884-1114
Entity
Organization
Contact information
Practice address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 884-3004
Mailing address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 884-3004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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