NPIMap

Organization Active NPI

Santo Domingo Behavioral Health

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
National Provider Identifier
1134248909
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SANTO DOMINGO BEHAVIORAL HEALTH
Practice address
200 Tesuque Street
Santo Domingo Pueblo, NM 87052-0130
Phone
(505) 465-2733
Fax
(505) 465-0433
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Luciano Calabaza
Title
Director
Phone
(505) 465-2733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NM Primary

Addresses

Primary practice location

200 Tesuque Street
Santo Domingo Pueblo, NM 87052-0130

Mailing address

PO Box 130
Santo Domingo Pueblo, NM 87052-0130
Phone (505) 465-2733

National Provider Directory

National Provider Directory
Tax ID family
Tara Littlejohn Gonzales MD - Arbor Pediatrics107 organizations share this tax ID, including this one

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1134248909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870520130",
            "telephone_number": "505-465-2733",
            "fax_number": "505-465-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TESUQUE STREET",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870520130",
            "telephone_number": "505-465-2733",
            "fax_number": "505-465-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTO DOMINGO BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CALABAZA",
        "authorized_official_first_name": "LUCIANO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-465-2733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santo Domingo Pueblo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.