| Upper Valley Behavioral Health Corp. | |
|
5690 Santa Teresita Dr Ste A2 Santa Teresa NM 88008-9211 | |
| (575) 332-4115 | |
| Not Available |
| Full Name | Upper Valley Behavioral Health Corp. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5690 Santa Teresita Dr Ste A2, Santa Teresa, New Mexico |
| Authorized Official Name and Position | Albert Hernandez (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8006756030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Valley Behavioral Health Corp. 5690 Santa Teresita Dr Ste A2 Santa Teresa NM 88008-9211 Ph: (575) 332-4115 | Upper Valley Behavioral Health Corp. 5690 Santa Teresita Dr Ste A2 Santa Teresa NM 88008-9211 Ph: (575) 332-4115 |
| NPI Number | 1689148389 |
|---|---|
| Provider Enumeration Date | 01/15/2019 |
| Last Update Date | 08/17/2021 |
| Certification Date | 08/17/2021 |
| Medicare PECOS PAC ID | 4284972571 |
|---|---|
| Medicare Enrollment ID | O20190212001489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689148389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Albert Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215400726 PECOS PAC ID: 5193063485 Enrollment ID: I20190212001550 |
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