| 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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