| Children's Behavioral Health Program | |
|
4601 College Blvd Farmington NM 87402-4609 | |
| (505) 566-3846 | |
| (505) 566-3687 |
| Full Name | Children's Behavioral Health Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4601 College Blvd, Farmington, New Mexico |
| Authorized Official Name and Position | Nicole Deherrera (PROGRAM DIRECTOR) |
| Authorized Official Contact | 5055663846 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Behavioral Health Program 4601 College Blvd Farmington NM 87402-4609 Ph: (505) 566-3846 | Children's Behavioral Health Program 4601 College Blvd Farmington NM 87402-4609 Ph: (505) 566-3846 |
| NPI Number | 1538414727 |
|---|---|
| Provider Enumeration Date | 07/13/2012 |
| Last Update Date | 07/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538414727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | M-07674 (New Mexico) | Primary |
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