| Corazon Behavioral Health Services Inc | |
|
1362 C Trinity Drive Los Alamos NM 87544 | |
| (505) 662-3600 | |
| (505) 662-0937 |
| Full Name | Corazon Behavioral Health Services Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1362 C Trinity Drive, Los Alamos, New Mexico |
| Authorized Official Name and Position | Reva Lee Heron (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5056623600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corazon Behavioral Health Services Inc 1362 C Trinity Drive Los Alamos NM 87544 Ph: (505) 662-3600 | Corazon Behavioral Health Services Inc 1362 C Trinity Drive Los Alamos NM 87544 Ph: (505) 662-3600 |
| NPI Number | 1366514861 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366514861 | NPI | - | NPPES |
| G9368 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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