Gallup Outpatient Treatment Center
NPI #1588925788 in Gallup, New Mexico
Provider Information
- NPI Number
- 1588925788
- Entity Type
- Organization
- Organization Name
- Gallup Outpatient Treatment Center
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jun 4, 2012
- Last Updated
- Mar 10, 2022
Practice Location
- Address
- 300 WEST NIZHONI BLVD.
- Address 2
- SUITE A
- City
- Gallup
- State
- New Mexico
- ZIP Code
- 87301
- Phone
- (505) 722-9470
Authorized Official
- Name
- VERA JOHN, LPCC
- Title
- BEHAVIORAL HEALTH DIRECTOR
- Phone
- (505) 722-9470
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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