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Organization
NEW MEXICO MENTAL HEALTH ASSOCIATES, LLC
Active
Organization
NEW MEXICO MENTAL HEALTH ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN RICHARD WHITE LISW, RN (CLINICAL SOCIAL WORKER)
(505) 414-7479
Entity
Organization
Contact information
Practice address
1515 GOLF COURSE RD SE STE 201, RIO RANCHO, NM 87124-2586
(505) 414-7479
Mailing address
1515 GOLF COURSE RD SE STE 201, RIO RANCHO, NM 87124-2586
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
I-07579
NM
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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