| Organization Name: | SANTA FE DIALECTICAL BEHAVIOR THERAPY, LLC |
| NPI Number: | 1023355252 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JILL M TIEDEMANN (TEAM LEADER) |
| Mailing Address: | 411 Saint Michaels Dr Suite 2 Santa Fe |
| State: | NM US |
| Postal Code: | 875057655 |
| Phone Number: | 5059838502 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2013 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |