Healthcare Provider Details

I. General information

NPI: 1780616854
Provider Name (Legal Business Name): FOCUSED RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 PENNSYLVANIA ST NE SUITE 500
ALBUQUERQUE NM
87110-3615
US

IV. Provider business mailing address

2625 PENNSYLVANIA ST NE SUITE 500
ALBUQUERQUE NM
87110-3615
US

V. Phone/Fax

Practice location:
  • Phone: 505-232-9115
  • Fax: 707-516-2492
Mailing address:
  • Phone: 505-232-9115
  • Fax: 707-516-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL NORMAN TUCKER
Title or Position: PRESIDENT
Credential: LADAC
Phone: 505-440-9545