NPIMap

Organization Active NPI

Teambuilders Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Santa Rosa, NM
National Provider Identifier
1760051130
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TEAMBUILDERS BEHAVIORAL HEALTH, LLC
Practice address
501 S 4TH St
Santa Rosa, NM 88435-2417
Phone
(575) 472-0745
Fax
(575) 472-0746
NPI assigned
Jun 21, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sun Vega
Title
Chief Operations Officer
Phone
(505) 235-4002

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211220001149 NM Part B Supplier - Clinic/Group Practice 5294126629 Receives reassigned benefits from 24 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Taos, NM; Santa Rosa, NM; Santa Fe, NM; Rio Rancho, NM; Raton, NM; Los Lunas, NM; Clayton, NM; Bernalillo, NM

National Provider Directory

National Provider Directory
Tax ID family
Teambuilders Behavioral Health LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

501 S 4th St
Santa Rosa, NM 88435
Phone (575) 472-0745

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

NPPES NPI Registry

Primary practice location

501 S 4TH St
Santa Rosa, NM 88435-2417

Mailing address

PO Box 28164
Santa Fe, NM 87592-8164
Phone (505) 501-8974

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
01981331MedicaidNM

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 5, 2024.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1760051130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28164",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875928164",
            "telephone_number": "505-501-8974",
            "fax_number": "505-501-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 4TH ST",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352417",
            "telephone_number": "575-472-0745",
            "fax_number": "575-472-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAMBUILDERS BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "SUN",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "505-235-4002"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01981331",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.