New Age Behavioral Health, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NEW AGE BEHAVIORAL HEALTH, LLC

Practice address

3600 Rodeo LN Ste 5
Santa Fe, NM 87507-6400

Phone

(505) 428-0039

Fax

(866) 793-0501

NPI assigned

Dec 31, 2019

Organization subpart

No

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

Authorized official

Name

Ashley Carro

Title

Owner

Phone

(505) 428-0039

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1386283869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 RODEO LN STE 5",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875076400",
            "telephone_number": "505-428-0039",
            "fax_number": "866-793-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 RODEO LN STE 5",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875076400",
            "telephone_number": "505-428-0039",
            "fax_number": "866-793-0501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 W Santa Clara Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Espanola",
            "state": "NM",
            "postal_code": "875329477",
            "country_code": "US",
            "telephone_number": "505-428-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW AGE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-31",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "CARRO",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-428-0039"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.