Taos Group Home, Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

0752 Issued in NM

Legal business name

TAOS GROUP HOME, INC.

Practice address

314 Don Fernando St
Pob 2360
Taos, NM 87571-5953

Phone

(575) 751-7037

Fax

(575) 751-3010

NPI assigned

Feb 7, 2007

Last updated

Apr 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Anthony Depaula

Title

Director of Operations

Phone

(505) 751-7037

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Casa de Corazon Other name

Tax ID family

Casa de Corazon2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Casa de Corazon

  • Community/Behavioral Health Agency
  • Taos, NM
  • NPI 1548432065
  NPD tax ID

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1649310749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 DON FERNANDO ST",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715953",
            "telephone_number": "575-751-7037",
            "fax_number": "575-751-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 DON FERNANDO ST",
            "address_2": "POB 2360",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715953",
            "telephone_number": "575-751-7037",
            "fax_number": "575-751-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAOS GROUP HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "DEPAULA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "505-751-7037",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NM",
            "license": "0752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84472855",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M1866",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11034254",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J6668",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R8496",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa de Corazon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Taos County Dental LLC
• Taos Dental Group
• Taos Emergency Group LLC
• Taos Family and Couples Institute
• Taos Family Dentistry, Inc
• Taos Health Systems Inc Holy Cross
• Taos Health Systems Inc Holy Cross Hospital (Holy Cross Hospital)
• Taos Health Systems, Inc., Holy Cross Hospital
• Taos Healthcare LLC (Taos Healthcare)
• Taos Home Dialysis, LLC

• Adolescent and Children Mental Health Clinic/Center in Taos, NM
• Providers in Taos, NM by specialty
• Adolescent and Children Mental Health Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.