Futura Vista Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0672 Issued in NM

Legal business name

FUTURA VISTA INC.

Doing business as

Futura Vista Group Home

Practice address

1205 Jones St
Clovis, NM 88101-5540

Phone

(505) 763-5887

Fax

(505) 762-9159

NPI assigned

Apr 20, 2007

Last updated

Aug 22, 2020By 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. William Walker, L.P.C.C.

Title

Clinical Director

Phone

(505) 607-7774

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Futura Vista Group Home Doing business as

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750508529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 JONES ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015540",
            "telephone_number": "505-763-5887",
            "fax_number": "505-762-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 JONES ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015540",
            "telephone_number": "505-763-5887",
            "fax_number": "505-762-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUTURA VISTA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "505-607-7774",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.P.C.C."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130187",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER ID",
            "identifier": "NM600911",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Futura Vista Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria M. Fredlund
• Viliami Fukofuka
• Chantilly Fulgham
• Heather D Fullerton, M.S., CFY-SLP
• Mahamadu A Fuseini, MD
• Evangelista M Gabaldon
• Michelle Gagen, FSS
• Mackenzie Gaines
• Tulasi S Gajula, DDS
• Caroline Gallegos, RN

• Mental Health Counselor in Clovis, NM
• Providers in Clovis, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.