# SAGE CHILD AND ADOLESCENT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAGE NEUROSCIENCE CENTER INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306569041
- **Legal business name:** SAGE NEUROSCIENCE CENTER INC
- **Authorized official:** DR. REUBEN SUTTER MD (CEO)
- **Authorized official phone:** (505) 884-1114

## Contact information

- **Practice address:** 7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
- **Practice address phone:** (505) 884-1114
- **Practice address fax:** (505) 884-3004
- **Mailing address:** 7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
- **Mailing address phone:** (505) 884-1114
- **Mailing address fax:** (505) 884-3004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/19/2022
- **Last updated:** 09/19/2022