| Nova Iii Behavioral Health Services | |
|
2418 E Highway 66 Gallup NM 87301-4767 | |
| (505) 297-3967 | |
| Not Available |
| Full Name | Nova Iii Behavioral Health Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2418 E Highway 66, Gallup, New Mexico |
| Authorized Official Name and Position | David Conejo (CEO) |
| Authorized Official Contact | 9038201142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Iii Behavioral Health Services 2418 E Highway 66 Gallup NM 87301-4767 Ph: (505) 297-3967 | Nova Iii Behavioral Health Services 2418 E Highway 66 Gallup NM 87301-4767 Ph: (505) 297-3967 |
| NPI Number | 1912667700 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 12/27/2021 |
| Certification Date | 12/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912667700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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