| Four Corners Behavioral Health | |
|
1500 S Second St Ste A Gallup NM 87301-5898 | |
| (507) 722-2923 | |
| Not Available |
| Full Name | Four Corners Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1500 S Second St Ste A, Gallup, New Mexico |
| Authorized Official Name and Position | Richard K Laughter (PSYCHAITRY) |
| Authorized Official Contact | 5058796575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Corners Behavioral Health 3300 Box Canyon Ave Gallup NM 87301-6940 Ph: (505) 722-2923 | Four Corners Behavioral Health 1500 S Second St Ste A Gallup NM 87301-5898 Ph: (507) 722-2923 |
| NPI Number | 1063008761 |
|---|---|
| Provider Enumeration Date | 12/16/2020 |
| Last Update Date | 12/16/2020 |
| Certification Date | 12/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063008761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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