EIGHT NORTHERN INDIAN PUEBLOS (NPI# 1679007744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679007744 |
| Entity Type | Organization |
| Organization Name | EIGHT NORTHERN INDIAN PUEBLOS |
| Other Organization Name | NEW MOON LODGE |
| Practice Address |
579 White Swan Rd 327 Eagle Drive Ohkay Owingeh NM 87566 |
| Mailing Address |
Po Box 969 327 Eagle Drive Ohkay Owingeh NM 87566-0969 |
| Practice Telephone | 5058522788 |
| Mailing Telephone | 5757517688 |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |
| Authorized Official Name | MS. DOROTHY ANNE FORBES (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 5056925034 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 28585810 | 05 |
| Other Name | Type Code |
|---|---|
| New Moon Lodge | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144754656 | Eight Northern Indian Pueblos | Case Management | 2201 San Pedro Dr Ne Ste 220, Albuquerque, NM 87110-4133 | 2017-04-12 |
| 1790179844 | Eight Northern Indian Pueblos | Substance Abuse Rehabilitation Facility | 1130 Butterfly Road, Taos, NM 87571 | 2015-03-26 |
| Street Address |
579 WHITE SWAN RD 327 EAGLE DRIVE |
| City | OHKAY OWINGEH |
| State | NM |
| Zip Code | 87566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336767524 | Alexander Andreas Kiryakakis | Counselor | 579 White Swan Rd., Ohkay Owingeh, NM 87566 | 2020-07-14 |
| 1780216101 | Ross Jenkins | Counselor | 579 White Swan Road, Ohkay Owingeh, NM 87566 | 2020-02-05 |
| 1033740881 | Katharine Hope Hendricks | Counselor | 346 Eagle Dr, Ohkay Owingeh, NM 87566-3600 | 2020-01-30 |
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912448499 | Jennifer Harrison-sanchez | Community Based Residential Treatment Facility, Mental Illness | 9961 Academy Rd Nw, Albuquerque, NM 87114-4245 | 2017-03-16 |
| 1205219771 | Dismas House | Community Based Residential Treatment Facility, Mental Illness | 701 Candelaria, Albuquerque, NM 87108 | 2015-07-02 |
| 1831584192 | Eight Northern Indian Pueblos Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1130 Butterfly Rd., Taos, NM 87571 | 2015-04-03 |
| 1366712283 | Native American Behavioral Health Services P.C. | Community Based Residential Treatment Facility, Mental Illness | 3300 Box Canyon Ave, Suite A, Gallup, NM 87301-6940 | 2012-01-10 |
| 1508143652 | Pasos Adelante Behavioral Health Services | Community Based Residential Treatment Facility, Mental Illness | 101 Maguey Ct Ste 1, Sunland Park, NM 88063-9513 | 2011-11-03 |
| 1255621058 | Hobbs Recovery House | Community Based Residential Treatment Facility, Mental Illness | 218 W Lea St, Hobbs, NM 88240-5110 | 2011-04-13 |
| 1962720771 | The Willow Foundation | Community Based Residential Treatment Facility, Mental Illness | 1405 Madison Ave, Roswell, NM 88203-5535 | 2010-05-04 |
| 1720246051 | International Word of Faith Ministry | Community Based Residential Treatment Facility, Mental Illness | 1605 E Dunn St, Hobbs, NM 88240-6704 | 2008-05-22 |
| 1063563385 | Life Healing Center of Santa Fe | Community Based Residential Treatment Facility, Mental Illness | 25 Vista Point Rd, Santa Fe, NM 87508-7800 | 2007-01-15 |
| 1326136532 | El Rocky Mountain Management & Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 712 Rencher St, 316 West 7th Street, Clovis, NM 88101-6560 | 2006-10-11 |
| Find all providers with the same taxonomy | ||||
| City | OHKAY OWINGEH |
| Zip Code | 87566 |
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| 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.