Pueblo De San Ildefonso

LBN: Pueblo De San Ildefonso
Pueblo De San Ildefonso is an health care organization with primary practice located at 2 Tunyo Po , Santa Fe NM 87506-7258. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Community Health Worker, Agencies / Case Management, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Public Health, State or Local. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Pueblo De San Ildefonso can be contacted via phone (505) 455-2395, or through Campbell, Troy via phone (505) 692-5943.

Contact Information

Primary practice address
2 Tunyo Po Santa Fe NM 87506-7258
Phone: (505) 455-2395
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Campbell, Troy Licensed Clinical Social Worker (LCSW)
Phone: (505) 692-5943

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Community Health Worker 172V00000X
Agencies / Case Management 251B00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Community Health 261QC1500X
Ambulatory Health Care Facilities / Public Health, State or Local 261QP0905X

Profile Details

NPI number 1184208225
LBN Legal business name Pueblo De San Ildefonso
DBA Doing business as
Authorized official Campbell, Troy Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2021
Last updated Mar 20th, 2022 - about 3 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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