Provider Demographics
NPI:1568517753
Name:NAVA DRUG & ALCOHOL
Entity Type:Organization
Organization Name:NAVA DRUG & ALCOHOL
Other - Org Name:NAVA COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LADAC, CGC
Authorized Official - Phone:505-524-2505
Mailing Address - Street 1:PO BOX 1078
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-1078
Mailing Address - Country:US
Mailing Address - Phone:505-524-2505
Mailing Address - Fax:505-524-2504
Practice Address - Street 1:715 E IDAHO AVE STE 4B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-4700
Practice Address - Country:US
Practice Address - Phone:505-524-2505
Practice Address - Fax:505-524-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM600345OtherVALUEOPTIONS PROVIDER ID