Healthcare Provider Details
I. General information
NPI: 1366074247
Provider Name (Legal Business Name): SANTA FE RECOVERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2020
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 SAINT MICHAELS DR
SANTA FE NM
87505-7615
US
IV. Provider business mailing address
2504 CAMINO ENTRADA
SANTA FE NM
87507-4851
US
V. Phone/Fax
- Phone: 505-471-4985
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELISA
SCHLEUSENER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 505-847-5422