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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