Organization
RIO VALLE BEHAVIORAL HEALTH CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEKSANDR GAZAROV M.D (OWNER,PRESIDENT)
(575) 589-2025
Entity
Organization
Contact information
Practice address
101 LIVINSTON LOOP, BLDG C SUITE 3, SANTA TERESA, NM 88008
(575) 589-2025
(575) 589-2605
Mailing address
101 LIVINGSTON LOOP,BLDG C, SUTIE 3, SANTA TERESA, NM 88008
(575) 589-2025
(575) 589-2605
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
MD2004-0757
NM
2084P0800X
Psychiatry Physician
Primary
MD2004-0757
NM
Other
Enumeration date
12/21/2006
Last updated
11/04/2013
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