State of New Mexico
Organization Active NPI Nursing Facility/Intermediate Care Facility · Las Vegas, NM
NPI 1992867998 · NPPES record last updated Feb 11, 2015
Key facts
- NPI
- 1992867998
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 5067 (NM)
- Legal business name
- STATE OF NEW MEXICO
- Practice address
- 3695 Hot Springs Blvd
Las Vegas, NM 87701-9549 - Phone
- (505) 454-2100
- NPI assigned
- Dec 15, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- STATE OF NEW MEXICO
Authorized official
- Name
- Mr. Charles Jaramillo
- Title
- Chief Operating Officer
- Phone
- (505) 454-2306
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 9
Practitioners 32
-
Michael Robert Padilla, APRN-PMHNP-BC
-
Tyler Scales, PMHNP
-
Bruce A Andersen, DPM
-
Danelle Baca, LMSW
-
Clarke A. Brunton Jr., D.O.
-
Wendy Dimmette, M.D.
-
Francisca L Gonzales, LMSW
-
Lea Henderson, NURSE PRACTITIONER
-
Mark M Luley, D.O.
-
Rita Troy McCallan, PMHNP
-
Franklin Miller, M.D.
-
Brenda Ortiz-Garcia, CNP
-
Christine Marie Padilla, FNP-C
-
Kimberly Monica Sena, DNP, PMHNP-BC
-
Thomas W. Strain, M.D.
-
Amy Weiss, CFNP
-
Chavonda M Briggs, PMHNP-BC
-
Andrew Robert Keyes, M.D.
-
Paul W. Bagwell Jr., PSYD
-
Mary Bunker, CNP
-
Helen Rosella Chrena, APRN
Affiliated clinicians 1
-
Wendy Dimmette, M.D.
Medicare Care Compare: Nursing home
- Listed as
- The NM Behavioral Health Institute at Las Vegas
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- Government - State
- Certified
- Sep 29, 1995
- Medicare certification status
- Active
- Certified beds
- 162 · 107.4 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $18,353
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM
Skilled nursing facility certification: CCN 325104
- Legal name
- STATE OF NEW MEXICO
- Doing business as
- NM BEHAVIORAL HEALTH INSTITUTE AT LAS VEGAS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 29, 1995
- Last certification
- Aug 23, 2024
- Beds
- 176
- Ownership / control type
- State
- Organization structure
- Government · Non-profit
- Enrollment address
- 3695 Hot Springs Blvd.
NM Behavioral Health Institute at Las Vegas
Las Vegas, NM 87701-9549 - Nursing home name
- THE NM BEHAVIORAL HEALTH INSTITUTE AT LAS VEGAS
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| State of New Mexico |
Operational/Managerial Control | Aug 24, 2009 | |
| Darlene Martinez |
W-2 Managing Employee | Apr 1, 2015 | |
| Charles Jaramillo |
W-2 Managing Employee |
Dec 1, 2008 | 50% |
| Operational/Managerial Control |
Dec 1, 2008 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090914000324 | NM | Part a Provider - Skilled Nursing Facility | 2062412869 | Practice locations: Las Vegas, NM |
| O20091021000191 | NM | Part B Supplier - Clinic/Group Practice | 2062412869 |
Receives reassigned benefits from 32 practitioners Practice locations: Las Vegas, NM |
National Provider Directory
- Tax ID family
- San Miguel Mora Communi
- Part of
- San Miguel Mora Communi
Locations
700 Friedman Ave
Las Vegas, NM 87701
Phone (505) 454-5100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 3035 | NM | |
| Psychiatric Hospital | 283Q00000X | 6011 | NM | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 5067 | NM | Yes |
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | 7257 | NM |
Addresses
Primary practice location
3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Mailing address
3695 Hot Springs Blvd.
Las Vegas, NM 87701-9549
Phone (505) 454-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM600303 | Medicaid | NM | |
| I0126 | Medicaid | NM | |
| 96296 | Medicaid | NM | |
| 50724 | Medicaid | NM | |
| M1545 | Medicaid | NM |
Other names
- NM Behavioral Health Institute at Las Vegas
Other providers in Las Vegas, NM
- State of New Mexico
- State of New Mexico
- State of New Mexico
- State of New Mexico
- State of New Mexico
- State of New Mexico Behavioral Health Inst.
- Catherine J Stauber
- Peter Stege
- Julia Stevens
- Sara Anne Stevens
All providers in Las Vegas, NM · Nursing Facility/Intermediate Care Facility in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.