Timothy M Gallegos, BMS/CSW PROG COORD
Individual provider Active NPI Counselor · Grants, NM
NPI 1720313109 · NPPES record last updated Jun 25, 2015
Key facts
- NPI
- 1720313109
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 210 E Santa Fe Ave
Suite a
Grants, NM 87020-2443 - Phone
- (505) 876-1890
- NPI assigned
- Oct 2, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
210 E Santa Fe Ave
Suite a
Grants, NM 87020-2443
Mailing address
2551 Coors Blvd NW
Albuquerque, NM 87120-1213
Phone (505) 338-3320
Other names
- Tim Gallegos
Other providers in Grants, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.