STATE OF THE HEART RECOVERY NPI 1700407277

NPI Information

NPI: 1700407277
Provider Name: STATE OF THE HEART RECOVERY
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 32D2199718

Address:
203 CALIFORNIA ST NE
ALBUQUERQUE, NM
ZIP 87108
Phone: (505) 308-8296
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STATE OF THE HEART RECOVERY is a methadone clinic center in Albuquerque, 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. STATE OF THE HEART RECOVERY NPI is 1700407277. The provider is registered as an organization entity type.

The provider's business location address is:

203 CALIFORNIA ST NE
ALBUQUERQUE, NM
ZIP 87108-802
Phone: (505) 308-8296

The provider's authorized official is Paul Thomas Chavez .
The authorized official title is Executive Director and has the following contact phone number (505) 688-1228.

The CLIA number assigned to this NPI record is 32D2199718 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/6/2020 and was last updated on 3/26/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2800X	Clinic/Center	Methadone			Yes

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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