CASA MESITA GROUP HOME, INC (NPI# 1770721292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770721292 |
Entity Type | Organization |
Organization Name | CASA MESITA GROUP HOME, INC |
Practice Address |
4007 Sycamore St Los Alamos NM 87544-1728 |
Practice Telephone | 5056624378 |
Practice Fax Number | 5056626834 |
Mailing Telephone | 5056624378 |
Mailing Fax Number | 5056626834 |
Enumeration Date | 2009-01-22 |
Last Update Date | 2009-01-22 |
Authorized Official Name | MR. DANIEL BARTHOLOMEW (PRESIDENT, BOARD OF DIRECTORS) |
Authorized Official Telephone | 5056624378 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 4119 | NM | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 0000M0196 | 05 |
Street Address |
4007 SYCAMORE ST |
City | LOS ALAMOS |
State | NM |
Zip Code | 87544-1728 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
Find all providers in zip 87544 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407376585 | Amikids Sandoval, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | #20 Pond Road, Sandoval, NM 87013 | 2017-06-21 |
1952549875 | Youth Odyssey Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 605 White Mountain Meadows Dr, Ruidoso, NM 88345-5816 | 2009-01-30 |
1942404090 | Zimmerman Consulting, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15 Jemez Drive, Los Lunas, NM 87031-7624 | 2007-06-13 |
1497872550 | New Vision Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 919 Rencher St, Clovis, NM 88101-5858 | 2007-03-23 |
1124156815 | Villa Santa Maria | Residential Treatment Facility, Emotionally Disturbed Children | 19 Cirquela Rd, Cedar Crest, NM 87008 | 2007-03-02 |
1407990500 | Nm Department of Health | Residential Treatment Facility, Emotionally Disturbed Children | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-02-20 |
1518010222 | Assurance Home Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1000 E 18th St, Roswell, NM 88201-7532 | 2007-01-18 |
1962569640 | Our Lady of Mount Carmel | Residential Treatment Facility, Emotionally Disturbed Children | 300 Mount Carmel Ave, Gallup, NM 87301-7411 | 2007-01-02 |
1306910484 | Cyfd-state of New Mexico-laplacita | Residential Treatment Facility, Emotionally Disturbed Children | 3102 N Florida Ave, Alamogordo, NM 88310-9713 | 2006-11-20 |
1699849794 | Cyfd-state of New Mexico | Residential Treatment Facility, Emotionally Disturbed Children | 3409 Pan American Fwy Ne, 3409 Pan American Frwy, Albuquerque, NM 87107-4786 | 2006-11-20 |
Find all providers with the same taxonomy |
City | LOS ALAMOS |
Zip Code | 87544 |
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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.