FT BAYARY MEDICAL CENTTER, YUCCA LODGE – NPI #1063641819
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

FT BAYARY MEDICAL CENTTER, YUCCA LODGE is a substance abuse rehabilitation facility located in FORT BAYARD, NM. NPPES has assigned the NPI number 1063641819 to FT BAYARY MEDICAL CENTTER, YUCCA LODGE on July 14, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FT BAYARY MEDICAL CENTTER, YUCCA LODGE” is a dba name, the actual legal business name for this organization is NM DEPARTMENT OF HEALTH. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FT BAYARY MEDICAL CENTTER, YUCCA LODGE below.

NPI Profile for
NM DEPARTMENT OF HEALTH

NPI Number
1063641819
Enumeration Date

(about 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NM DEPARTMENT OF HEALTH
Doing Business As (dba): FT BAYARY MEDICAL CENTTER, YUCCA LODGE
Primary location
100 CALLE DE CENTRAL
FORT BAYARD, NM 88036
Phone: (575) 537-8831 Fax: (575) 537-8886
Mailing address
PO BOX 36216
FORT BAYARD, NM 88036-6216
Phone: (575) 537-8831 Fax: (575) 537-8886
Organization Subpart
Yes - FT BAYARY MEDICAL CENTTER, YUCCA LODGE is subpart of another organization.
Authorized Official
ALFRED CHAVEZ
CLINICAL SUPERVISOR
Phone: (575) 537-8831
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
NM 5610

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.