INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT


Address: 413 Grant Ave, Santa Fe, NM 87501-1301
Phone: 5059868481

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
NM 42735513 05

Other Provider/Organization Names

Other Name Type Code
Intermountain Youth Centers Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 413 GRANT AVE
City SANTA FE
State NM
Zip Code 87501-1301

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City SANTA FE
Zip Code 87501

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Dataset Information

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.

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