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Contact Information

GRANO DE ORO FAMILY MENTAL HEALTH SERVICES
1920 7TH ST
LAS VEGAS, NM87701-4956
 Phone: 505-617-6313
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for GRANO DE ORO FAMILY MENTAL HEALTH SERVICES

NPI Number 1023334083
LBN Legal business name GRANO DE ORO FAMILY MENTAL HEALTH SERVICES
Authorized official RODOLFO GRANO - (CLINICAL PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/15/2010
Last updated 04/15/2010 - About 16 years ago
Identifiers
NM License # 0811
NM Medicaid 17480221
Other NM301219 MEDICARE
NM Other 1356452981 NPI
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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