Healthcare Provider Details

I. General information

NPI: 1801032958
Provider Name (Legal Business Name): ALBUQUERQUE TREATMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2008
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 MADEIRA DR SE
ALBUQUERQUE NM
87108-2963
US

IV. Provider business mailing address

7134 S YALE AVE STE 560
TULSA OK
74136-6352
US

V. Phone/Fax

Practice location:
  • Phone: 505-262-1538
  • Fax:
Mailing address:
  • Phone: 501-269-1395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNM
# 5
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: SCOTT THOMPSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 918-289-0270