Gallup Outpatient Treatment Center | |
300 West Nizhoni Blvd. Suite A Gallup NM 87301 | |
(505) 722-9470 | |
(505) 722-9570 |
Full Name | Gallup Outpatient Treatment Center |
---|---|
Speciality | Community/behavioral Health |
Location | 300 West Nizhoni Blvd., Gallup, New Mexico |
Authorized Official Name and Position | Vera John (BEHAVIORAL HEALTH DIRECTOR) |
Authorized Official Contact | 5057229470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gallup Outpatient Treatment Center 300 West Nizhoni Blvd. Suite A Gallup NM 87301 Ph: (505) 722-9470 | Gallup Outpatient Treatment Center 300 West Nizhoni Blvd. Suite A Gallup NM 87301 Ph: (505) 722-9470 |
NPI Number | 1588925788 |
---|---|
Provider Enumeration Date | 06/04/2012 |
Last Update Date | 03/10/2022 |
Certification Date | 03/10/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588925788 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 0131901 (New Mexico) | Primary |
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