Bloom Haven Behavioral Health LLC
Organization Active NPI Community/Behavioral Health Agency · Rio Rancho, NM
NPI 1124800776 · NPPES record last updated Jun 29, 2026
Key facts
- NPI
- 1124800776
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- BLOOM HAVEN BEHAVIORAL HEALTH LLC
- Practice address
- 741 Tiwa LN NE
Rio Rancho, NM 87124-1510 - Phone
- (505) 900-4029
- Fax
- (505) 317-7133
- NPI assigned
- Oct 18, 2023
- Organization subpart
- No
Authorized official
- Name
- Lisa Lujan
- Title
- Ceo
- Phone
- (505) 916-4729
Practitioners 8
-
Amanda Clearwater, LADAC
-
Amelia F La Plante Horne, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240305003699 | NM | Part B Supplier - Clinic/Group Practice | 0446695027 |
Receives reassigned benefits from 3 practitioners Practice locations: Rio Rancho, NM |
National Provider Directory
Locations
1380 Rio Rancho Blvd SE
Rio Rancho, NM 87124
Phone (505) 916-4729
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
741 Tiwa LN NE
Rio Rancho, NM 87124-1510
Mailing address
1380 Rio Rancho Blvd SE # 431
Rio Rancho, NM 87124-1006
Phone (505) 900-4029
Other providers in Rio Rancho, NM
- Patrick Blanks
- Christine Blaser
- Christina D Blea
- Walter Anthony Blea
- Brian Duane Blocker
- Carrie Joanne Bloomer
- Blue Phoenix Therapy LLC
- Blueeyes Speech and Language Services
- William K Blythe
- Victoria L Bobchak
All providers in Rio Rancho, 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 Jun 29, 2026. 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.