CORAZON BEHAVIORAL HEALTH SERVICES INC (NPI# 1366514861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366514861 |
| Entity Type | Organization |
| Organization Name | CORAZON BEHAVIORAL HEALTH SERVICES INC |
| Practice Address |
1362 C Trinity Drive Los Alamos NM 87544 |
| Practice Telephone | 5056623600 |
| Practice Fax Number | 5056620937 |
| Mailing Telephone | 5056623600 |
| Mailing Fax Number | 5056620937 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. REVA LEE HERON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5056623600 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | G9368 | 05 |
| Street Address |
1362 C TRINITY DRIVE |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846708 | Integrated Energies LLC | Clinic/Center | 3000 Trinity Dr Apt 59, Los Alamos, NM 87544-2340 | 2020-09-21 |
| 1922519735 | Jade Therapy, LLC | Clinic/Center | 1505 15th St Ste C, Los Alamos, NM 87544-3000 | 2017-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547904 | Pawsitively Transformational Health and Wellness Inc | Clinic/Center | 715 Dooley St, Alamogordo, NM 88310-8203 | 2020-11-01 |
| 1073110920 | Nambe Pueblo | Clinic/Center | 16a Tayeh Huu U, Pueblo of Nambe, NM 87506 | 2020-10-05 |
| 1053922104 | Indigo Psychotherapy, LLC | Clinic/Center | 6701 Kiowa Ave Ne, Albuquerque, NM 87110-2144 | 2020-08-12 |
| 1548878200 | Lenore Engelhardt Inc | Clinic/Center | 205 Horton Ln Nw, Albuquerque, NM 87114-1052 | 2020-07-20 |
| 1013531037 | Behavioral Healthcare Services, Inc. | Clinic/Center | 227b Hwy 314 Nw, Los Lunas, NM 87031-8476 | 2020-06-05 |
| 1538783568 | Behavioral Healthcare Services, Inc. | Clinic/Center | 2052 Galisteo St, Santa Fe, NM 87505-2100 | 2020-06-05 |
| 1003446790 | Drgmed, Inc. | Clinic/Center | 210 Crestwood Ct, Gallup, NM 87301-7120 | 2020-01-22 |
| 1871137042 | State of The Heart Recovery | Clinic/Center | 203 California St Ne, Albuquerque, NM 87108-1802 | 2019-10-31 |
| 1659926913 | Deep Roots Counseling, LLC | Clinic/Center | 210 Truman St Ne, Albuquerque, NM 87108-1333 | 2019-08-05 |
| 1841850526 | New Horizons Counseling Center LLC | Clinic/Center | 900 Marshall St, Truth Or Consequences, NM 87901-6600 | 2019-06-16 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
Please comment or provide details below to improve the information on CORAZON BEHAVIORAL HEALTH SERVICES INC.
| 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.