DESERT BLOOM TELEPSYCH SERVICES LLC


Address: 8605 Vineyard Ridge Rd Ne, Albuquerque, NM 87122-2623
Phone: 5056206389

DESERT BLOOM TELEPSYCH SERVICES LLC (NPI# 1336503176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336503176
Entity Type Organization
Organization Name DESERT BLOOM TELEPSYCH SERVICES LLC
Practice Address 8605 Vineyard Ridge Rd Ne
Albuquerque
NM 87122-2623
Practice Telephone 5056206389
Mailing Telephone 5056206389
Enumeration Date 2016-04-07
Last Update Date 2016-04-07
Authorized Official Name DEBRA MARIE STANGER (PMHNP-BC SOLE OWNER)
Authorized Official Telephone 5058562262
Authorized Official Credential CNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
CNP-01597 NM Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NM 78935784 05

Office Location

Street Address 8605 VINEYARD RIDGE RD NE
City ALBUQUERQUE
State NM
Zip Code 87122-2623

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932372935 Debra Stanger Registered Nurse 8605 Vineyard Ridge Rd Ne, Albuquerque, NM 87122-2623 2008-04-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1457716664 Raymond Martinez Pharmacist 7847 Tramway Ne, Albuquerque, NM 87122 2015-12-15
1891181913 Paul Wright Occupational Therapist 30 Canocito Drive Ne, Albuquerque, NM 87122 2015-04-15
1356736615 Tracy Pfeifer Day Training/Habilitation Specialist 8920 Holly Avenue Ne, Suite 102b, Albuquerque, NM 87122 2015-04-03
1346595071 Jonathan Harper Kelley Dentist 9015 Paseo Del Norte Ne Ste A, Albuquerque, NM 87122 2012-07-18
1639444946 Charlsey Leigh Mcdonald Physical Therapist 7920 Carmel Ave. Ne, Suite 2, Albuquerque, NM 87122 2012-03-20
1235462250 Pamela Kay Limke Pharmacist 12112 Summer Wind Pl Ne, Albuquerque, NM 87122 2009-09-09
1437395332 High Desert Pedicatrics PC Pediatrics 8650 Almeda Boulevard, Ne, Unit 101 E, Albuquerque, NM 87122 2008-12-23
1952427510 Thomas Harry Heflin Dentist 8000 Carmel Ave, Albuquerque, NM 87122 2007-03-22
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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1245869130 Indigo Psychiatric Services Nurse Practitioner 609 Gold Ave Sw Ste 1-c, Albuquerque, NM 87102-3119 2020-04-03
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1437407301 Jayanna Warwick Nurse Practitioner 2015 Wyoming Blvd Ne, Suite F, Albuquerque, NM 87112-2622 2012-08-26
1780939975 Brenda Kaye Mckenna Nurse Practitioner Unm Department of Psychiatry and Behavioral Health Scie, 1 University of New Mexico, Albuquerque, NM 87131 2012-07-13
1194091603 Awareness Integration LLC Nurse Practitioner 219 Sierra Dr Se, Unit A, Albuquerque, NM 87108-2714 2012-03-29
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Competitor

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City ALBUQUERQUE
Zip Code 87122

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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