SANTO DOMINGO BEHAVIORAL HEALTH (NPI# 1134248909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134248909 |
| Entity Type | Organization |
| Organization Name | SANTO DOMINGO BEHAVIORAL HEALTH |
| Practice Address |
200 Tesuque Street Santo Domingo Pueblo NM 87052-0130 |
| Mailing Address |
Po Box 130 Santo Domingo Pueblo NM 87052-0130 |
| Practice Telephone | 5054652733 |
| Practice Fax Number | 5054650433 |
| Mailing Telephone | 5054652733 |
| Mailing Fax Number | 5054650433 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LUCIANO CALABAZA (DIRECTOR) |
| Authorized Official Telephone | 5054652733 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | ========= | NM | Agencies |
| Street Address |
200 TESUQUE STREET |
| City | SANTO DOMINGO PUEBLO |
| State | NM |
| Zip Code | 87052-0130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902353972 | Karin Luzzi | Registered Nurse | 100 Highway 22 W, Santo Domingo, NM 87052 | 2016-09-07 |
| 1043676273 | Kyle Maestas | Physician Assistant | 85 West Hwy 22, Santo Domingo, NM 87052 | 2016-01-04 |
| 1639579352 | Cynthia Brooks | Registered Nurse | 85 West Highway 22 Santo Domingo Health Center, Santo Domingo, NM 87052 | 2014-08-29 |
| 1720335219 | Samantha Nicole Torres | Pharmacist | 85 W Hwy 22, Santo Domingo, NM 87052 | 2012-08-14 |
| 1780835504 | Roger L Leonard | Clinic/Center | #85 West Hwy 22, Santo Domingo, NM 87052 | 2008-10-10 |
| 1679766489 | Santo Domingo Tribe | Ambulance | #1 Tesuque St., Ems Headquarters, Santo Domingo Pueblo, NM 87052 | 2007-08-24 |
| 1326165994 | Santa Domingo Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 340 San Ildefonso St, Santa Domingo, NM 87052 | 2007-03-26 |
| 1467509612 | Andrea Heeter | Specialist/Technologist | Santo Domingo Health Center, 85 Hwy 22, Santo Domingo, NM 87052 | 2007-01-03 |
| 1164531950 | Jonathan Neil Trujillo | Pharmacist | 85 West Highway 22, Santo Domingo Health Center, Santo Domingo, NM 87052 | 2006-08-29 |
| 1053920520 | John Patirck Pagett | Registered Nurse | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2020-07-30 |
| Find all providers in zip 87052 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396944211 | Santo Domingo Behavioral Health Program | Community/Behavioral Health | 10 Tesuque St, Santo Domingo Pueblo, NM 87052-9998 | 2007-07-11 |
| 1336659077 | Kewa Pueblo Health Corporation | Community/Behavioral Health | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2017-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345328 | The People's Counseling and Consulting, LLC | Community/Behavioral Health | 4718 Idlewilde Ln Se, Albuquerque, NM 87108-3424 | 2020-10-28 |
| 1861090342 | Rio Grande Emdr Therapy, LLC | Community/Behavioral Health | 6 Sierra Vista Drive, Cedar Crest, NM 87008 | 2020-10-15 |
| 1306443924 | Recovery Innovations, Inc | Community/Behavioral Health | 1850 Copper Loop Bldg B, Las Cruces, NM 88005-8139 | 2020-10-06 |
| 1689271413 | Thriving Mind LLC | Community/Behavioral Health | 4612 Huyana Dr Nw, Albuquerque, NM 87120-5597 | 2020-10-05 |
| 1922612951 | Connections Counseling LLC | Community/Behavioral Health | 11920 Dahlia Ave Se, Albuquerque, NM 87123-2470 | 2020-09-08 |
| 1538771357 | Ariane Mahmud-ghazi, LLC | Community/Behavioral Health | 1604 Young St, Santa Fe, NM 87505-3504 | 2020-08-21 |
| 1790301026 | Capitan Therapy & Behavioral Health | Community/Behavioral Health | 102 East Smokey Bear Blvd, Capitan, NM 88316 | 2020-06-23 |
| 1396360871 | Integrity Behavior Improvement Services, LLC | Community/Behavioral Health | 1916 Amherst Dr Ne, Albuquerque, NM 87106-1105 | 2020-06-10 |
| 1871116236 | Carsal LLC | Community/Behavioral Health | 6501 4th St Nw Ste E2, Los Ranchos, NM 87107-5800 | 2020-05-20 |
| 1023647096 | Inner Peace Outreach LLC | Community/Behavioral Health | 3107 San Mateo Blvd Ne, Albuquerque, NM 87110-1921 | 2020-04-02 |
| Find all providers with the same taxonomy | ||||
| City | SANTO DOMINGO PUEBLO |
| Zip Code | 87052 |
Please comment or provide details below to improve the information on SANTO DOMINGO BEHAVIORAL HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.