Organization
NEW VISION BEHAVIORAL HEALTH, LLC
Active
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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