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RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED NPI 1194924928


NPI Information

NPI: 1194924928
Provider Name: RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED

Doing Business As: RIO GRANDE ALCOHOLISM TREATMENT PROGRAM, INC.

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
105 PASEO DEL CANON W STE A
TAOS, NM
ZIP 87571
Phone: (575) 737-5533
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RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED is a substance abuse rehabilitation facility in Taos, NM. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED NPI is 1194924928. The provider is registered as an organization entity type.
The provider Is Doing Business As Rio Grande Alcoholism Treatment Program, Inc..

The provider's business location address is:

105 PASEO DEL CANON W STE A
TAOS, NM
ZIP 87571-943
Phone: (575) 737-5533
Fax: (575) 737-5534

The provider's authorized official is Lawrence Medina .
The authorized official title is Executive Director and has the following contact phone number (575) 737-5533.

The enumeration date for this NPI number is 7/12/2007 and was last updated on 1/19/2024.


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
1324500000XSubstance Abuse Rehabilitation Facility5517NEW MEXICONo
2324500000XSubstance Abuse Rehabilitation FacilityYes

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
183774556MEDICAIDNEW 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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