Teambuilders Behavioral Health, LLC

Organization Active NPI Community/Behavioral Health Agency · Clayton, NM

NPI 1295304657 · NPPES record last updated Feb 5, 2024

Key facts

NPI
1295304657
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
TEAMBUILDERS BEHAVIORAL HEALTH, LLC
Practice address
834 Main St
Clayton, NM 88415-2900
Phone
(575) 729-1953
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

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 11

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

Practitioners 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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 (12 organizations share this tax ID)

Locations

2600 The American Rd SE
Ste 100
Rio Rancho, NM 87124
Phone (505) 404-6907

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

834 Main St
Clayton, NM 88415-2900

Mailing address

PO Box 28164
Santa Fe, NM 87592-8164
Phone (505) 501-8974

Other identifiers

IdentifierTypeStateIssuer
01981331MedicaidNM

Other providers in Clayton, NM

All providers in Clayton, NM · Community/Behavioral Health Agency in New Mexico

Sources for this page

Verify at the official NPI Registry.