Organization
NEW MEXICO MENTAL HEALTH ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN RICHARD WHITE LISW, RN (CLINICAL SOCIAL WORKER)
(505) 414-7479
Entity
Organization
Contact information
Practice address
1515 GOLF COURSE RD SE STE 201, RIO RANCHO, NM 87124-2586
(505) 414-7479
Mailing address
1515 GOLF COURSE RD SE STE 201, RIO RANCHO, NM 87124-2586
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
I-07579
NM
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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