NPIMap

Organization Active NPI

New Mexico Teen Challenge, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Tijeras, NM
National Provider Identifier
1508488677
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 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
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
James Goins Jr.NPI 1992361091
Title
Clinical Supervisor
Phone
(484) 868-0584

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1508488677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20610",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871540610",
            "telephone_number": "706-596-8731",
            "fax_number": "706-596-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAMINO ORO CT",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870597924",
            "telephone_number": "706-596-8731",
            "fax_number": "706-596-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO TEEN CHALLENGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "GOINS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "484-868-0584",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tijeras, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.