Organization Active NPI

High Desert Behavioral Health LLC

Doing business as Mindful Medication Management

  • Family Medicine Physician
  • Farmington, NM
National Provider Identifier
1508548850
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HIGH DESERT BEHAVIORAL HEALTH LLC
Doing business as
Mindful Medication Management
Practice address
3510 Messina Dr
Farmington, NM 87402-4782
Phone
(505) 591-0636
NPI assigned
Aug 7, 2023
Last updated
Sep 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Kaylene Cribbs, CNPNPI 1245527837
Title
Owner
Phone
(505) 591-0636

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3510 Messina Dr
Farmington, NM 87402-4782

Mailing address

3510 Messina Dr
Farmington, NM 87402-4782
Phone (505) 591-0636

Other names 1

  • Mindful Medication Management Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240410000313 NM Part B Supplier - Clinic/Group Practice 4789022740 Receives reassigned benefits from 1 practitioner
Practice locations: Farmington, NM

National Provider Directory

National Provider Directory

Locations

3510 Messina Dr
Farmington, NM 87402
Phone (505) 320-5553

Practitioners & affiliated clinicians

Practitioners 1

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": "1691366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1508548850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 MESSINA DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024782",
            "telephone_number": "505-591-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 MESSINA DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024782",
            "telephone_number": "505-591-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-23",
        "status": "A",
        "authorized_official_last_name": "CRIBBS",
        "authorized_official_first_name": "KAYLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-591-0636",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Medication Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.