Jack L. Humphries, Lisw, Ltd.

LBN: Jack L. Humphries, Lisw, Ltd.
Jack L. Humphries, Lisw, Ltd. is an health care organization with primary practice located at 8800 Palomar Ave Ne , Albuquerque NM 87109-7205. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Jack L. Humphries, Lisw, Ltd. can be contacted via phone (505) 620-5225, or through Humphries, Jack L. via phone (505) 620-5225.

Contact Information

Primary practice address
8800 Palomar Ave Ne Albuquerque NM 87109-7205
Phone: (505) 620-5225
Fax: (505) 798-1743
Website:
Map and Directions
Authorized official contact:
Name: Humphries, Jack L. LISW
Phone: (505) 620-5225

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X I-3613 New Mexico

Profile Details

NPI number 1043376288
LBN Legal business name Jack L. Humphries, Lisw, Ltd.
DBA Doing business as
Authorized official Humphries, Jack L. LISW
Entity Organization
Organization subpart 1 No
Enumeration date Dec 30th, 2006
Last updated Aug 22nd, 2020 - about 5 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 1043376288 NPPES
New Mexico MEDICAID 24500721
New Mexico MEDICAID 37982788
New Mexico MEDICAID D-4525
New Mexico MEDICAID NM60084

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