Organization
INSIDE OUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE GUTIERREZ CPSW, CCSS, CHW (EXECUTIVE DIRECTOR)
(505) 367-3500
Entity
Organization
Contact information
Practice address
908 N RIVERSIDE DR STE 6, ESPANOLA, NM 87532-2916
(505) 367-3500
(505) 367-3503
Mailing address
908 N RIVERSIDE DR STE 6, ESPANOLA, NM 87532-2916
(505) 367-3500
(505) 367-3503
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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