Provider Demographics
NPI:1972385029
Name:THREE CROSSES BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:THREE CROSSES BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-339-4579
Mailing Address - Street 1:2560 SAMARITAN DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1170
Mailing Address - Country:US
Mailing Address - Phone:800-421-8274
Mailing Address - Fax:
Practice Address - Street 1:2560 SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1170
Practice Address - Country:US
Practice Address - Phone:800-421-8274
Practice Address - Fax:575-592-2224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE CROSSES REGIONAL HOSPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty