Healthcare Provider Details

I. General information

NPI: 1093935959
Provider Name (Legal Business Name): UNICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 MOON ST NE
ALBUQUERQUE NM
87112-3935
US

IV. Provider business mailing address

2201 SAN PEDRO DR NE BLDG 3-210
ALBUQUERQUE NM
87110-4130
US

V. Phone/Fax

Practice location:
  • Phone: 505-271-0329
  • Fax: 505-271-4957
Mailing address:
  • Phone: 505-271-0329
  • Fax: 505-271-4957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberM1099
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License NumberM1099
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA DUNAGAN
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 505-510-0921