# NEW MEXICO TEEN CHALLENGE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508488677
- **Authorized official:** JAMES GOINS JR. (CLINICAL SUPERVISOR)
- **Authorized official phone:** (484) 868-0584

## Contact information

- **Practice address:** 1 CAMINO ORO CT, TIJERAS, NM 87059-7924
- **Practice address phone:** (706) 596-8731
- **Practice address fax:** (706) 596-8732
- **Mailing address:** PO BOX 20610, ALBUQUERQUE, NM 87154-0610
- **Mailing address phone:** (706) 596-8731
- **Mailing address fax:** (706) 596-8732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |

## Other

- **Enumeration date:** 05/12/2020
- **Last updated:** 07/07/2023