New Moon Lodge

LBN: Eight Northern Indian Pueblos
New Moon Lodge is an health care organization with primary practice located at 579 White Swan Rd 327 Eagle Drive, Ohkay Owingeh NM 87566. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness is the primary health care specialty. Eight Northern Indian Pueblos can be contacted via phone (505) 852-2788, or through Forbes, Dorothy Anne via phone (505) 692-5034.

Contact Information

Primary practice address
579 White Swan Rd 327 Eagle Drive Ohkay Owingeh NM 87566
Phone: (505) 852-2788
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Forbes, Dorothy Anne Licensed Clinical Social Worker (LCSW)
Phone: (505) 692-5034

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1679007744
LBN Legal business name Eight Northern Indian Pueblos
DBA Doing business as New Moon Lodge
Authorized official Forbes, Dorothy Anne Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2017
Last updated Apr 17th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679007744 NPPES
New Mexico MEDICAID 28585810

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