Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Other names
Presbyterian Kaseman Psych Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE MAXWELL (VP FINANCE/CFO DELIVERY SYSTEM)
(505) 923-5353
Entity
Organization
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-5300
(505) 291-5301
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
273R00000X
Psychiatric Hospital Unit
Primary
6114
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00993
—
NM
01
—
225720 0
MEDICARE PART B
NM
Enumeration date
12/13/2005
Last updated
07/30/2015
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