Provider Demographics
NPI:1124637541
Name:BEHAVIORAL MEDICINE AND ASSESSMENT OF NEW MEXICO LLC
Entity type:Organization
Organization Name:BEHAVIORAL MEDICINE AND ASSESSMENT OF NEW MEXICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:KIMBALL
Authorized Official - Last Name:HASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-302-1492
Mailing Address - Street 1:PO BOX 45121
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-5121
Mailing Address - Country:US
Mailing Address - Phone:505-302-1492
Mailing Address - Fax:
Practice Address - Street 1:3520 CALLE CUERVO NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-9220
Practice Address - Country:US
Practice Address - Phone:505-302-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty