NPIMap

Organization Active NPI

Teambuilders Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Taos, NM
National Provider Identifier
1386213759
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TEAMBUILDERS BEHAVIORAL HEALTH, LLC
Practice address
105 Pasel del Canon West
Taos, NM 87571-5953
Phone
(575) 751-7037
Fax
(575) 758-3459
NPI assigned
Jun 21, 2021
Last updated
Feb 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Sun Vega
Title
Chief Operations Officer
Phone
(505) 235-4002

Specialties & licenses 2

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

Addresses

Primary practice location

105 Pasel del Canon West
Taos, NM 87571-5953

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
01981331MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Teambuilders Behavioral Health LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

105 Paseo del Canon W
Taos, NM 87571
Phone (575) 751-7037

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1386213759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28164",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875928164",
            "telephone_number": "505-501-8974",
            "fax_number": "505-501-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PASEL DEL CANON WEST",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715953",
            "telephone_number": "575-751-7037",
            "fax_number": "575-758-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAMBUILDERS BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "SUN",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "505-235-4002"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01981331",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.