KEWA PUEBLO HEALTH CORPORATION

Community/Behavioral Health

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

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Contact Information

KEWA PUEBLO HEALTH CORPORATION

85 WEST HIGHWAY 22
SANTO DOMINGO PUEBLO, NM 87052

Phone:
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Community/Behavioral Health	251S00000X

Indicates primary specialty

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NPI Profile & details for KEWA PUEBLO HEALTH CORPORATION

NPI # 1336659077

LBN Legal business name KEWA PUEBLO HEALTH CORPORATION

Authorized official SURAJ AGBOKE - (BUSINESS OFIICE MANAGER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 10/09/2017

Last updated 03/18/2026 - About 3 months ago

Identifiers

Medicaid

82674060

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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