Healthcare Provider Details

I. General information

NPI: 1265683049
Provider Name (Legal Business Name): NEW MEXICO TREATMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1264 RODEO RD
SANTA FE NM
87505
US

IV. Provider business mailing address

7134 S YALE AVE STE 560
TULSA OK
74136-6352
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-2129
  • Fax: 505-992-1149
Mailing address:
  • Phone: 505-982-2129
  • Fax: 505-992-1149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberN/A
License Number StateNM

VIII. Authorized Official

Name: SCOTT THOMPSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 918-289-0270