New Mexico Teen Challenge, Inc.

Organization Active NPI Addiction (Substance Use Disorder) Counselor · Tijeras, NM

NPI 1508488677 · NPPES record last updated Jul 7, 2023

Key facts

NPI
1508488677
Entity type
Organization (NPI type 2)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Legal business name
NEW MEXICO TEEN CHALLENGE, INC.
Practice address
1 Camino Oro CT
Tijeras, NM 87059-7924
Phone
(706) 596-8731
Fax
(706) 596-8732
NPI assigned
May 12, 2020
Organization subpart
No

Authorized official

Name
James Goins Jr.
Title
Clinical Supervisor
Phone
(484) 868-0584

Practitioners 3

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YA0400X Yes
Mental Health Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YM0800X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

1 Camino Oro CT
Tijeras, NM 87059-7924

Mailing address

PO Box 20610
Albuquerque, NM 87154-0610
Phone (706) 596-8731

Other providers in Tijeras, NM

All providers in Tijeras, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.