National Provider Identifier Database

NEW MEXICO DEPARTMENT OF HEALTH
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

NEW MEXICO DEPARTMENT OF HEALTH
84 ESTANCIA ROAD
BELEN, NM87002
Phone: 505-864-4015
Fax: 505-841-5316
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for NEW MEXICO DEPARTMENT OF HEALTH

NPI Number 1124189048
Legal business name
LBN
NEW MEXICO DEPARTMENT OF HEALTH
Authorized official CAITLYN BLAINE - (FINANCE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 12/13/2006
Last updated 02/24/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: 5240
  • NM Medicaid: M2402

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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