Organization
SANTA FE MOUNTAIN CENTER INC
Active
Other names
The Mountain Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN DIXON (EXECUTIVE DIRECTOR)
(505) 490-3549
Entity
Organization
Contact information
Practice address
1524 BISHOPS LODGE ROAD, TESUQUE, NM 87574-0449
(505) 983-6158
(505) 983-0460
Mailing address
PO BOX 449, TESUQUE, NM 87574-0449
(505) 983-6158
(505) 983-0460
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM600490
VALUEOPTIONSNM PROVIDER #
NM
Enumeration date
06/07/2007
Last updated
07/01/2020
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