National Provider Identifier Database

SANDIA CREST MENTAL HEALTH LLC
Psychiatric/Mental Health


Contact Information

SANDIA CREST MENTAL HEALTH LLC
1701 US ROUTE 66
SUITE D
MORIARTY, NM87035
Phone: 505-384-1034
Fax:
Website:
Specialty Taxonomy Code
* Psychiatric/Mental Health 363LP0808X
Psychiatric/Mental Health, Child & Adolescent 364SP0807X

* Indicates primary specialty

NPI Profile & details for SANDIA CREST MENTAL HEALTH LLC

NPI Number 1932373743
Legal business name
LBN
SANDIA CREST MENTAL HEALTH LLC
Authorized official EDWARD LOBAUGH - (OWNDER)
Entity Organization
Organization subpart No
Enumeration date 04/14/2008
Last updated 09/19/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: R45675

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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