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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