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Organization

NEW VISION BEHAVIORAL HEALTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN RICHARD WHITE CNP, PMHNP-BC, LCSW (OWNER)
(505) 414-7479
Entity
Organization

Contact information

Practice address
1515 GOLF COURSE RD SE, STE 202, RIO RANCHO, NM 87124-2071
(505) 414-7479
(505) 892-5449
Mailing address
1515 GOLF COURSE RD SE, STE 202, RIO RANCHO, NM 87124-2071

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
05/16/2013
Last updated
05/16/2013
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