GREATER SANTA ROSA COUNCIL ON ALCOHOLISM NPI 1417370131

NPI Information

  • NPI: 1417370131
  • Provider Name: GREATER SANTA ROSA COUNCIL ON ALCOHOLISM
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • :
  • CLIA Number: 32D2069992
  • Address: 1047 LAKE DR
    SANTA ROSA, NM
    ZIP 88435
  • Phone: (575) 472-5383

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NPI Details

GREATER SANTA ROSA COUNCIL ON ALCOHOLISM is a mental health (including community mental health center) clinic center in Santa Rosa, NM. GREATER SANTA ROSA COUNCIL ON ALCOHOLISM NPI is 1417370131. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1047 LAKE DR
SANTA ROSA, NM
ZIP 88435-561
Phone: (575) 472-5383
Fax: (575) 472-5384

The provider's authorized official is Cayetana Zamora .
The authorized official title is Executive Director Of Operations and has the following contact phone number (575) 472-5383.

The CLIA number assigned to this NPI record is 32D2069992 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2014 and was last updated on 7/15/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)I-04593NEW MEXICOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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