Provider Demographics
NPI:1467753954
Name:SUBSTANCE ABUSE & MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:SUBSTANCE ABUSE & MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LADAC,CS CFAE
Authorized Official - Phone:575-257-8942
Mailing Address - Street 1:108 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6045
Mailing Address - Country:US
Mailing Address - Phone:575-257-8942
Mailing Address - Fax:575-257-8943
Practice Address - Street 1:108 SERVICE RD
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6045
Practice Address - Country:US
Practice Address - Phone:575-257-8942
Practice Address - Fax:575-257-8943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM006181251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health