Organization
GRACE HAVEN BEHAVIORAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKIE STANDIFER (CEO)
(480) 765-0866
Entity
Organization
Contact information
Practice address
1209 MOUNTAIN ROAD PL NE STE N, ALBUQUERQUE, NM 87110-7845
(844) 914-7223
Mailing address
1209 MOUNTAIN ROAD PL NE STE N, ALBUQUERQUE, NM 87110-7845
(844) 914-7223
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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