Teambuilders Behavioral Health, LLC
Organization Active NPI Community/Behavioral Health Agency · Raton, NM
NPI 1043889413 · NPPES record last updated Feb 5, 2024
Key facts
- NPI
- 1043889413
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- TEAMBUILDERS BEHAVIORAL HEALTH, LLC
- Practice address
- 101 Letton Dr
Raton, NM 87740-4366 - Phone
- (575) 383-2065
- Fax
- (575) 347-1190
- NPI assigned
- Jun 21, 2021
- Organization subpart
- No
Authorized official
- Name
- Sun Vega
- Title
- Chief Operations Officer
- Phone
- (505) 235-4002
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 11
Practitioners 6
-
Laura L Lansrud-Lopez, LPCC, LPAT, ATR-BC
-
Jackie Lynne West, LPCC, LADAC
-
Maryann Malena, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211220001149 | NM | Part B Supplier - Clinic/Group Practice | 5294126629 |
Receives reassigned benefits from 24 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Taos, NM; Santa Rosa, NM; Santa Fe, NM; Rio Rancho, NM; Raton, NM; Los Lunas, NM; Clayton, NM; Bernalillo, NM |
National Provider Directory
- Tax ID family
- Teambuilders Behavioral Health LLC
Locations
101 Letton Dr
Raton, NM 87740
Phone (575) 383-2065
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
101 Letton Dr
Raton, NM 87740-4366
Mailing address
PO Box 28164
Santa Fe, NM 87592-8164
Phone (505) 501-8974
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01981331 | Medicaid | NM |
Other providers in Raton, NM
- Aileen C Swope
- Aisa Malonzo Tagle
- Marilou Renie Tagliatela
- Melanie Tapia
- Tdcrotinger
- Tiger Den Wellness Center
- Jameela Bai Tiku
- Omkar Nath Tiku
- TKM Corporation
- Ryan Trejo
All providers in Raton, NM · Community/Behavioral Health Agency in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.