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Organization

CORAZON BEHAVIORAL HEALTH SERVICES INC

Active
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Organization

CORAZON BEHAVIORAL HEALTH SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. REVA LEE HERON PHD (EXECUTIVE DIRECTOR)
(505) 662-3600
Entity
Organization

Contact information

Practice address
1362 C TRINITY DRIVE, LOS ALAMOS, NM 87544
(505) 662-3600
(505) 662-0937
Mailing address
1362 C TRINITY DRIVE, LOS ALAMOS, NM 87544
(505) 662-3600
(505) 662-0937

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9368
—
NM
Enumeration date
11/14/2006
Last updated
08/22/2020
About Stedi
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