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RECOVERY SERVICES OF NEW MEXICO NPI 1194104141


NPI Information

NPI: 1194104141
Provider Name: RECOVERY SERVICES OF NEW MEXICO

Doing Business As: MEDMARK TREATMENT CENTERS ROSWELL

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 32D2094259

Address:
1107 S ATKINSON AVE
ROSWELL, NM
ZIP 88203
Phone: (575) 578-4826
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RECOVERY SERVICES OF NEW MEXICO is a methadone clinic center in Roswell, NM. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. RECOVERY SERVICES OF NEW MEXICO NPI is 1194104141. The provider is registered as an organization entity type.
The provider Is Doing Business As Medmark Treatment Centers Roswell.

The provider's business location address is:

1107 S ATKINSON AVE
ROSWELL, NM
ZIP 88203-154
Phone: (575) 578-4826

The provider's authorized official is Michael Saul .
The authorized official title is Vp and has the following contact phone number (214) 379-3300.

The CLIA number assigned to this NPI record is 32D2094259 - other - treatment program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2015 and was last updated on 2/13/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2800XClinic/CenterMethadoneCL00010987NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101227335MEDICAIDNEW MEXICO

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: 4/28/2024

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