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Organization

PUEBLO OF ISLETA BEHAVIORAL HEALTH

Active
Parent organization
PUEBLO OF ISLETA HEALTH CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
PUEBLO OF ISLETA HEALTH CENTER
Authorized official
BARBARTA A MONTANO (BUSINESS MANAGER)
(505) 869-4863
Entity
Organization

Contact information

Practice address
01 SAGEBRUSH ST, ISLETA, NM 87022-0000
(505) 869-4863
(505) 869-4881
Mailing address
PO BOX 640, ISLETA, NM 87022-0000
(505) 869-4863
(505) 869-4881

Taxonomy

Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3803775
NM
Enumeration date
01/23/2008
Last updated
01/23/2008
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