Organization
PUEBLO OF ACOMA
Active
Organization
PUEBLO OF ACOMA
Active
Other names
Acoma Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PAHOS LCSW, LADAC (LEAD CLINICIAN, BHS)
(505) 552-6661
Entity
Organization
Contact information
Practice address
45 PINSBAARI DRIVE, ACOMA, NM 87034-0328
(505) 552-6661
(505) 552-6426
Mailing address
PO BOX 328, ACOMA, NM 87034-0328
(505) 552-6661
(505) 552-6426
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
01/04/2016
Last updated
07/01/2016
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