Healthcare Provider Details

I. General information

NPI: 1750210472
Provider Name (Legal Business Name): NEXUS PEDIATRIC THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 SAN PEDRO DR NE STE 101G
ALBUQUERQUE NM
87110-4197
US

IV. Provider business mailing address

2501 SAN PEDRO DR NE STE 101G
ALBUQUERQUE NM
87110-4197
US

V. Phone/Fax

Practice location:
  • Phone: 855-426-5871
  • Fax:
Mailing address:
  • Phone: 855-426-5871
  • 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 TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KRISTOPHER GUARCH
Title or Position: PRESIDENT
Credential: M.ED
Phone: 855-426-5871