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OVER THE EDGE GROUP HOME FOR DISABLE NPI 1598058232


NPI Information

NPI: 1598058232
Provider Name: OVER THE EDGE GROUP HOME FOR DISABLE

Doing Business As: OVER THE EDGE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
7010 PHOENIX AVE NE APT 310
ALBUQUERQUE, NM
ZIP 87110
Phone: (505) 508-5708
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OVER THE EDGE GROUP HOME FOR DISABLE is a clinic center in Albuquerque, NM. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). OVER THE EDGE GROUP HOME FOR DISABLE NPI is 1598058232. The provider is registered as an organization entity type.
The provider Is Doing Business As Over The Edge.

The provider's business location address is:

7010 PHOENIX AVE NE APT 310
ALBUQUERQUE, NM
ZIP 87110-505
Phone: (505) 508-5708

The provider's authorized official is Autrell Sherrod Brown .
The authorized official title is Owner/ceo and has the following contact phone number (505) 463-6328.

The enumeration date for this NPI number is 5/26/2011 and was last updated on 5/26/2011.


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
1261Q00000XClinic/CenterYes

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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