Organization
STATE OF NEW MEXICO
Active
Parent organization
STATE OF NEW MEXICO
Other names
NM Behavioral Health Institute at Las Vegas
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW MEXICO
Authorized official
MR. CHARLES JARAMILLO (CHIEF OPERATING OFFICER)
(505) 454-2306
Entity
Organization
Contact information
Practice address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-2100
Mailing address
3695 HOT SPRINGS BLVD., LAS VEGAS, NM 87701-9549
(505) 454-2100
(505) 454-2130
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
3035
NM
283Q00000X
Psychiatric Hospital
6011
NM
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
5067
NM
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
7257
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50724
—
NM
05
—
96296
—
NM
05
—
I0126
—
NM
05
—
M1545
—
NM
05
—
NM600303
—
NM
Enumeration date
12/15/2006
Last updated
02/11/2015
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