JICARILLA BEHAVIORAL HEALTH
NPI 1508051061
Community/Behavioral Health in Dulce, NM

Q: What is Jicarilla Apache Nation's NPI number?

The NPI number for Jicarilla Apache Nation is 1508051061. It was assigned to this organization in the NPPES registry on September 7, 2007. The provider is doing business as Jicarilla Behavioral Health.

Q: What is Jicarilla Apache Nation's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since September 07, 2007CLIA 32D2061646 · Waiver

109 SENECA DRIVE, DULCE, NM 87528(505) 759-3162(505) 759-3588 Get Directions Write a Review

NPPES record last updated: September 7, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jicarilla Behavioral Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JICARILLA BEHAVIORAL HEALTH (NPI 1508051061) is a healthcare organization registered as a community/behavioral health in Dulce, New Mexico and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through July 1, 2027 and lists Levi Pesata, President, as its authorized official.

NPPES Registry Identity

NPI1508051061

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameJICARILLA APACHE NATION

Location Address109 SENECA DRIVEDulce, NM 87528

Mailing AddressPo Box 546Dulce, NM 87528-0546 · (505) 759-3162 · Fax (505) 759-3588

Phone(505) 759-3162

Fax(505) 759-3588

Organization SubpartNo

Authorized OfficialLevi PesataPresident · (505) 759-3242

Enumeration DateSeptember 7, 2007

✔ NPI 1508051061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

109 SENECA DRIVE, Dulce, NM 87528

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Other Names 1

Doing Business AsJicarilla Behavioral Health

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 32D2061646

Jicarilla Apache Nation Dialysis Center · Dulce, NM

Active · expires Jul 1, 2027

CLIA Number32D2061646

Laboratory TypeEnd Stage Renal Disease Dialysis Facility

Certificate Effective DateJuly 2, 2025

Certificate Expiration DateJuly 1, 2027

Laboratory DirectorCharmain Madero

Laboratory Phone(505) 982-9427

Laboratory LocationJicarilla Apache Nation Dialysis Center450 N Mundo Drive, Dulce, NM 87528

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARLENE JOY VELARDE LISW

Social Worker

109 SENECA DRIVE
DULCE, NM 87528

Rio Arriba County (505) 759-3162

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jicarilla Apache Nation's NPI number?

The NPI number for Jicarilla Apache Nation is 1508051061. It was assigned to this organization in the NPPES registry on September 7, 2007. The provider is doing business as Jicarilla Behavioral Health.

Where is Jicarilla Apache Nation located?

Jicarilla Apache Nation is located at 109 Seneca Drive, Dulce, NM 87528. The listed phone number is (505) 759-3162.

What is Jicarilla Apache Nation's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Jicarilla Apache Nation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 32D2061646) is associated with this NPI, valid through July 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jicarilla Apache Nation was last updated on September 7, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.