Native American Behavioral Health Services P.C.
Psychiatry & Neurology, Psychiatry in Gallup, NM. Organization (NPI-2).
NPI number1366712283
StatusActive
Last updated in NPPESAug 21, 2024
Details
- NPI
- 1366712283
- Entity type
- Organization (NPI-2)
- Legal business name
- Native American Behavioral Health Services P.C.
- Organization subpart
- No
- Enumeration date
- Jan 10, 2012
- Certification date
- Aug 21, 2024
- Last updated
- Aug 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 283Q00000X | Psychiatric Hospital | MD2008-0055 | NM | |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | MD2008-0055 | NM | |
| 324500000X | Substance Abuse Rehabilitation Facility | 11959 | NV |
Practice location
1500 S Second St Ste AGallup, NM 87301-5898
Phone 505-722-2923 · Fax 505-722-2961
Mailing address
1500 S Second St Ste AGallup, NM 87301-5898
Phone 505-722-2923 · Fax 505-722-2961
Other practice locations
3300 Box Canyon Ave
Gallup, NM 87301-6940
Gallup, NM 87301-6940
Phone 505-879-6575 · Fax 505-722-2961
Authorized official
Richard K Laughter
President
5058796575
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