Provider Demographics
NPI:1023101094
Name:ALBUQUERQUE BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:ALBUQUERQUE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRASHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD LPCC
Authorized Official - Phone:505-830-6500
Mailing Address - Street 1:PO BOX 13387
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87192-3387
Mailing Address - Country:US
Mailing Address - Phone:505-830-6500
Mailing Address - Fax:505-830-6527
Practice Address - Street 1:8100 MOUNTAIN RD NE STE 200B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7833
Practice Address - Country:US
Practice Address - Phone:505-830-6500
Practice Address - Fax:505-830-6527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health