Healthcare Provider Details

I. General information

NPI: 1487529418
Provider Name (Legal Business Name): BOCEPHUS RECOVERY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 YALE BLVD SE
ALBUQUERQUE NM
87106-4200
US

IV. Provider business mailing address

10823 DENTON RD SW
ALBUQUERQUE NM
87121-2595
US

V. Phone/Fax

Practice location:
  • Phone: 210-984-4620
  • Fax:
Mailing address:
  • Phone: 210-984-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA LOPEZ
Title or Position: OWNER
Credential:
Phone: 210-984-4620