Healthcare Provider Details

I. General information

NPI: 1508011230
Provider Name (Legal Business Name): FOCUS ON RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2008
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 SAINT MICHAELS DR
SANTA FE NM
87505-7619
US

IV. Provider business mailing address

460 SAINT MICHAELS DR
SANTA FE NM
87505-7619
US

V. Phone/Fax

Practice location:
  • Phone: 505-992-0226
  • Fax: 505-989-1470
Mailing address:
  • Phone: 505-992-0226
  • Fax: 505-989-1470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: LIZ CERVIO
Title or Position: DIRECTOR
Credential: LMFT
Phone: 505-992-0226