Healthcare Provider Details

I. General information

NPI: 1861848632
Provider Name (Legal Business Name): RECOVERY SERVICES OF NEW MEXICO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 3RD ST NW
ALBUQUERQUE NM
87102-2235
US

IV. Provider business mailing address

1720 LAKEPOINTE DR STE 117
LEWISVILLE TX
75057-6425
US

V. Phone/Fax

Practice location:
  • Phone: 505-717-2397
  • Fax:
Mailing address:
  • Phone: 214-379-3300
  • Fax: 214-853-9018

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 Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRUCE JARVIE
Title or Position: VP, TREASURER
Credential:
Phone: 214-379-3300