Organization
HALVORSON HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI LEWIS (EXECUTIVE DIRECTOR)
(505) 326-2736
Entity
Organization
Contact information
Practice address
108 N BEHREND AVE, FARMINGTON, NM 87401-8448
(505) 326-2736
Mailing address
PO BOX 15067, FARMINGTON, NM 87401-5067
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1079A
NM
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
1079A
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M0115
—
NM
05
—
M1925
—
NM
Enumeration date
09/20/2006
Last updated
09/11/2025
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