| Isleta Health Center Bh | |
|
01 Sagebrush St Isleta NM 87022-0000 | |
| (505) 869-4863 | |
| (505) 869-4811 |
| Full Name | Isleta Health Center Bh |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 01 Sagebrush St, Isleta, New Mexico |
| Authorized Official Name and Position | Volelle K Zamora (CEO) |
| Authorized Official Contact | 5058694094 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Isleta Health Center Bh Po Box 912157 Denver CO 80291-2157 Ph: (505) 869-4863 | Isleta Health Center Bh 01 Sagebrush St Isleta NM 87022-0000 Ph: (505) 869-4863 |
| NPI Number | 1114040714 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 05/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114040714 | NPI | - | NPPES |
| 3803775 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 501C (New Mexico) | Primary |
Pueblo Of Isleta Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 01 Sagebrush St, Isleta, NM 87022 Phone: 505-869-4863 Fax: 505-869-4881 |