# NOVA III BEHAVIORAL HEALTH SERVICES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1912667700
- **Authorized official:** MR. DAVID CONEJO (CEO)
- **Authorized official phone:** (903) 820-1142

## Contact information

- **Practice address:** 2418 E HIGHWAY 66, GALLUP, NM 87301-4767
- **Practice address phone:** (505) 297-3967
- **Mailing address:** 2418 E HIGHWAY 66, GALLUP, NM 87301-4767
- **Mailing address phone:** (505) 297-3967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/21/2021
- **Last updated:** 12/27/2021