San Juan Health And Wellness Center

LBN: San Juan Health And Wellness Center
San Juan Health And Wellness Center is an health care organization with primary practice located at 4801 N Butler Ave Ste 1101, Farmington NM 87401-1013. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is the primary health care specialty. San Juan Health And Wellness Center can be contacted via phone (505) 327-0002, or through Diaz, Misty Dawn via phone (505) 327-0002.

Contact Information

Primary practice address
4801 N Butler Ave Ste 1101 Farmington NM 87401-1013
Phone: (505) 327-0002
Fax: (505) 325-9443
Website:
Map and Directions
Authorized official contact:
Name: Diaz, Misty Dawn
Phone: (505) 327-0002

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1568998029
LBN Legal business name San Juan Health And Wellness Center
DBA Doing business as
Authorized official Diaz, Misty Dawn
Entity Organization
Organization subpart 1 No
Enumeration date May 3rd, 2017
Last updated Dec 29th, 2023 - about last year

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 1568998029 NPPES
New Mexico MEDICAID 86337556
New Mexico Other 2782

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