Organization
NEW MEXICO BEHAVIORAL HEALTH INSTITUTE
Active
Organization
NEW MEXICO BEHAVIORAL HEALTH INSTITUTE
Active
Parent organization
STATE OF NEW MEXICO
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW MEXICO
Authorized official
CORINNE F DOMINGUEZ (CBS DIRECTOR)
(505) 454-5134
Entity
Organization
Contact information
Practice address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
(505) 454-5172
Mailing address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-5100
(505) 454-5172
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-07539
NM
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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