NPIMap

Organization Active NPI

PB & J Family Services, Inc.

  • Community/Behavioral Health Agency
  • Albuquerque, NM
National Provider Identifier
1164579082
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PB & J FAMILY SERVICES, INC.
Practice address
1101 Lopez Rd SW
Albuquerque, NM 87105-3954
Phone
(505) 877-7060
Fax
(505) 877-7063
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Authorized official

Name
Ms. Susannah Burke, MS, MSW, LISW
Title
Exec. Director
Phone
(505) 877-7060

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Early Intervention Provider Agency 252Y00000X NM
Developmental Disabilities Clinic/Center 261QD1600X
Health Service Clinic/Center 261QH0100X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1101 Lopez Rd SW
Albuquerque, NM 87105-3954

Mailing address

1101 Lopez SW
Albuquerque, NM 87105
Phone (505) 877-7060

Other identifiers 2

IdentifierTypeStateIssuer
NM600403MedicaidNM
000Q3467MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
PB J Family Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1164579082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LOPEZ SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87105",
            "telephone_number": "505-877-7060",
            "fax_number": "505-877-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LOPEZ RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053954",
            "telephone_number": "505-877-7060",
            "fax_number": "505-877-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PB & J FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "SUSANNAH",
        "authorized_official_title_or_position": "EXEC. DIRECTOR",
        "authorized_official_telephone_number": "505-877-7060",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, MSW, LISW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NM600403",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Q3467",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.