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Greater Santa Rosa Council on Alcoholism

Organization Active NPI Community/Behavioral Health Agency · Santa Rosa, NM

NPI 1962580175 · NPPES record last updated Jul 15, 2025

Key facts

NPI
1962580175
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
LISW 1041CO700X (NM)
Legal business name
GREATER SANTA ROSA COUNCIL ON ALCOHOLISM
Practice address
1047 Lake Dr
Santa Rosa, NM 88435-2561
Phone
(575) 472-5383
NPI assigned
Nov 2, 2006
Organization subpart
No

Authorized official

Name
Cayetana Zamora
Title
Executive Director of Operations
Phone
(575) 472-5383

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Greater Santa Rosa Council on Alcoholism (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LISW 1041CO700X NM Yes

Addresses

Primary practice location

1047 Lake Dr
Santa Rosa, NM 88435-2561

Mailing address

419 S 2ND St
Tucumcari, NM 88401-2859
Phone (505) 461-3572

Other identifiers

IdentifierTypeStateIssuer
I0930OtherNMLISW
NMA3588MedicaidNM

Other names

  • Professional Counseling Associates New Mexico Doing business as
  • Professional Counseling Associates of NM Doing business as

Other providers in Santa Rosa, NM

All providers in Santa Rosa, NM · Community/Behavioral Health Agency in New Mexico

Sources for this page

Verify at the official NPI Registry.