Children'S Community Mental Health Clinic

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

171M00000X Issued in NM

Legal business name

CHILDREN'S COMMUNITY MENTAL HEALTH CLINIC

Practice address

5100 2ND St NW
Albuquerque, NM 87107-4009

Phone

(505) 342-3799

Fax

(505) 342-3758

NPI assigned

Aug 29, 2008

Organization subpart

Yes

Parent organization

BERNALILLO COUNTY JUVENILE DETENTION YOUTH SERVICES CENTERAs reported in NPPES

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

Authorized official

Name

Mr. Solomon T Foulk, M.S.

Title

Comprehensive Community Support Ser

Phone

(505) 342-3799

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Bernalillo County

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1649428855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 2ND ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074009",
            "telephone_number": "505-342-3799",
            "fax_number": "505-342-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 2ND ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074009",
            "telephone_number": "505-342-3799",
            "fax_number": "505-342-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S COMMUNITY MENTAL HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BERNALILLO COUNTY JUVENILE DETENTION YOUTH SERVICES CENTER",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "FOULK",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "COMPREHENSIVE COMMUNITY SUPPORT SER",
        "authorized_official_telephone_number": "505-342-3799",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NM",
            "license": "171M00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VNM00719NO",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack Chien, DO
• Child Psychological Services of New Mexico, LLC
• Kacee Child
• Edward L Childers, DO
• Childhood Is Calling, LLC
• Children'S Treatment Center
• Childrens Psychiatric Center Outpatient Services
• Demetra Childress, MS
• Kayli R Childs, RN
• Lance Chilton, MD

• Case Management Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Case Management Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.