NPIMap

Organization Active NPI

Trauma Treatment Center LLC

  • Community/Behavioral Health Agency
  • Rio Rancho, NM
National Provider Identifier
1427567486
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TRAUMA TREATMENT CENTER LLC
Practice address
1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612
Phone
(505) 289-1042
Fax
(505) 466-5895
NPI assigned
Sep 21, 2017
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Kathlene Bunch, LPCC
Title
Owner
Phone
(505) 289-1042

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 0185071 NM
Mental Health Counselor 101YM0800X NU
Occupational Therapist 225X00000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612

Mailing address

1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612
Phone (505) 289-1042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190226000483 NM Part B Supplier - Clinic/Group Practice 9739428301 Receives reassigned benefits from 5 practitioners
Practice locations: Rio Rancho, NM

National Provider Directory

National Provider Directory

Locations

1316 Jackie Rd SE
Ste 900
Rio Rancho, NM 87124
Phone (505) 289-1042

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1427567486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246612",
            "telephone_number": "505-289-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246612",
            "telephone_number": "505-289-1042",
            "fax_number": "505-466-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-21",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "BUNCH",
        "authorized_official_first_name": "KATHLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-289-1042",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NM",
            "license": "0185071",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.