Organization
TAOS PUEBLO BEHAVIORAL HEALTH
Active
Parent organization
PUEBLO OF TAOS -CMS
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUEBLO OF TAOS -CMS
Authorized official
DR. JOHN MARK MESH PH.D. (CLINICAL SUPERVISOR)
(575) 770-9651
Entity
Organization
Contact information
Practice address
1090 GOAT SPRINGS ROAD, TAOS, NM 87571
(575) 758-6900
(575) 751-5219
Mailing address
PO BOX 1846, TAOS, NM 87571
(575) 758-6900
(575) 751-5219
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72150041
—
NM
Enumeration date
06/14/2021
Last updated
06/14/2021
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