Provider Demographics
NPI:1548439136
Name:PASOS ADELANTE BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:PASOS ADELANTE BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:ISRAEL
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-680-0035
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:BERINO
Mailing Address - State:NM
Mailing Address - Zip Code:88024-0176
Mailing Address - Country:US
Mailing Address - Phone:575-680-0035
Mailing Address - Fax:505-589-2758
Practice Address - Street 1:101 E JOY ROAD
Practice Address - Street 2:
Practice Address - City:BERINO
Practice Address - State:NM
Practice Address - Zip Code:88024
Practice Address - Country:US
Practice Address - Phone:575-680-0035
Practice Address - Fax:505-589-2758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management