Healthcare Provider Details

I. General information

NPI: 1548125701
Provider Name (Legal Business Name): ROADRUNNER PANORAMIC RECOVERY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3841 MIDWAY PL NE
ALBUQUERQUE NM
87109-5814
US

IV. Provider business mailing address

3841 MIDWAY PL NE
ALBUQUERQUE NM
87109-5814
US

V. Phone/Fax

Practice location:
  • Phone: 505-808-3754
  • Fax:
Mailing address:
  • Phone: 505-808-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAYLA FLOWERS
Title or Position: DIRECTOR OF OPERATIONS
Credential: MSHI,MBA
Phone: 505-808-3754