INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT (NPI# 1639397441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639397441 |
Entity Type | Organization |
Organization Name | INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT |
Other Organization Name | INTERMOUNTAIN YOUTH CENTERS |
Practice Address |
413 Grant Ave Santa Fe NM 87501-1301 |
Mailing Address |
Po Box 1089 Santa Fe NM 87504-1089 |
Practice Telephone | 5059868481 |
Practice Fax Number | 5059868491 |
Mailing Telephone | 5059868481 |
Mailing Fax Number | 5059868491 |
Enumeration Date | 2007-04-24 |
Last Update Date | 2008-05-30 |
Authorized Official Name | MS. ROBIN EDWARDS (OPERATIONS MANAGER) |
Authorized Official Telephone | 5059868481 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251B00000X | Case Management | Agencies | ||
N | 253J00000X | Foster Care Agency | Agencies | ||
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 1111 | NM | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 42735513 | 05 |
Other Name | Type Code |
---|---|
Intermountain Youth Centers | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104900539 | Intermountain Centers for Human Development | Residential Treatment Facility, Emotionally Disturbed Children | 633 Aqua Fria, Santa Fe, NM 87501 | 2006-10-24 |
1861042012 | Intermountain Centers for Human Development | Clinic/Center | 401 N Bonita Ave, Tucson, AZ 85709-5001 | 2019-09-18 |
1760932859 | Intermountain Centers for Human Development | Community/Behavioral Health | 5055 E Broadway Blvd Ste C104, Tucson, AZ 85711-3641 | 2016-10-12 |
1104122902 | Intermountain Centers for Human Development | Community Based Residential Treatment Facility, Mental Illness | 4025 N Drake Pl, Tucson, AZ 85749-8299 | 2011-01-27 |
1598910044 | Intermountain Centers for Human Development | Residential Treatment Facility, Emotionally Disturbed Children | 4025 N Drake Pl, Tucson, AZ 85749-8299 | 2008-11-25 |
1285722611 | Intermountain Centers for Human Development | Community/Behavioral Health | 1020 S Harrison Rd, Ste 100, Tucson, AZ 85748 | 2006-10-11 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT | 7820 E Broadway Ste 100, Po Box 17749, Tucson, AZ 85710 |
Street Address |
413 GRANT AVE |
City | SANTA FE |
State | NM |
Zip Code | 87501-1301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841775327 | Rasanjana Bhandari | Behavior Technician | 1505 Paseo De Conquistadora, Santa Fe, NM 87501 | 2018-10-01 |
1497102172 | New Mexico Neurodiagnostics, LLC | Clinic/Center | 150 Washington Ave., Ste. #201-220, Office 224, Santa Fe, NM 87501 | 2016-05-23 |
1831557891 | Jane Berger | Social Worker | 300 Griffin St Ste 213, Santa Fe, NM 87501 | 2016-02-05 |
1316325061 | Serenity Wellness Center of Santa Fe, LLC | Counselor | 343 E Palace Ave, Santa Fe, NM 87501 | 2015-05-14 |
1902209497 | Mdlive Medical Group Nm LLC | Counselor | 123 Marcy Street, Santa Fe, NM 87501 | 2014-09-29 |
1396154183 | Julie Price | Counselor | 1 Montoya Cir, Santa Fe, NM 87501 | 2014-08-06 |
1053609487 | Michael Shawn Haner | Acupuncturist | 909 Early St., Santa Fe, NM 87501 | 2011-07-19 |
1396045316 | Dana Moore | Counselor | 950 Canyon Rd., Santa Fe, NM 87501 | 2010-10-25 |
1720394232 | Susan Nelsen | Social Worker | 118 Huddleson St, Santa Fe, NM 87501 | 2010-08-20 |
1033434543 | Anthony R Moya | Social Worker | 501 Franklin Ave Ofc 6, Santa Fe, NM 87501 | 2010-03-29 |
Find all providers in zip 87501 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104900539 | Intermountain Centers for Human Development | Residential Treatment Facility, Emotionally Disturbed Children | 633 Aqua Fria, Santa Fe, NM 87501 | 2006-10-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407376585 | Amikids Sandoval, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | #20 Pond Road, Sandoval, NM 87013 | 2017-06-21 |
1952549875 | Youth Odyssey Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 605 White Mountain Meadows Dr, Ruidoso, NM 88345-5816 | 2009-01-30 |
1770721292 | Casa Mesita Group Home, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4007 Sycamore St, Los Alamos, NM 87544-1728 | 2009-01-22 |
1942404090 | Zimmerman Consulting, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15 Jemez Drive, Los Lunas, NM 87031-7624 | 2007-06-13 |
1497872550 | New Vision Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 919 Rencher St, Clovis, NM 88101-5858 | 2007-03-23 |
1124156815 | Villa Santa Maria | Residential Treatment Facility, Emotionally Disturbed Children | 19 Cirquela Rd, Cedar Crest, NM 87008 | 2007-03-02 |
1407990500 | Nm Department of Health | Residential Treatment Facility, Emotionally Disturbed Children | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-02-20 |
1518010222 | Assurance Home Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1000 E 18th St, Roswell, NM 88201-7532 | 2007-01-18 |
1962569640 | Our Lady of Mount Carmel | Residential Treatment Facility, Emotionally Disturbed Children | 300 Mount Carmel Ave, Gallup, NM 87301-7411 | 2007-01-02 |
1306910484 | Cyfd-state of New Mexico-laplacita | Residential Treatment Facility, Emotionally Disturbed Children | 3102 N Florida Ave, Alamogordo, NM 88310-9713 | 2006-11-20 |
Find all providers with the same taxonomy |
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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.