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RE-CYCLED MAN LLC NPI 1568866085


NPI Information

NPI: 1568866085
Provider Name: RE-CYCLED MAN LLC

Doing Business As: A NEW AWAKENING RIO RANCHO

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 32D2113373

Address:
1207 GOLF COURSE RD SE
SUITE C
RIO RANCHO, NM
ZIP 87124
Phone: (505) 994-4100
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RE-CYCLED MAN LLC is a community behavioral health in Rio Rancho, NM. The provider is 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. RE-CYCLED MAN LLC NPI is 1568866085. The provider is registered as an organization entity type.
The provider Is Doing Business As A New Awakening Rio Rancho.

The provider's business location address is:

1207 GOLF COURSE RD SE
SUITE C
RIO RANCHO, NM
ZIP 87124-999
Phone: (505) 994-4100
Fax: (505) 994-1229

The provider's authorized official is Erick Brian Pacheco .
The authorized official title is Owner and has the following contact phone number (505) 489-4935.

The CLIA number assigned to this NPI record is 32D2113373 - other - behavioral hlth opt facil with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/13/2014 and was last updated on 7/5/2016.


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
1251S00000XCommunity/Behavioral HealthYes

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
132D2113373OTHERNEW MEXICOCLINICAL LABORATORY IMPROVMENT AMENDMENTS CERTIFICATE OF WAIVER
2481793MEDICARE UPINNEW MEXICO
393588755MEDICAIDNEW 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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