Healthcare Provider Details

I. General information

NPI: 1750194411
Provider Name (Legal Business Name): LONGVIEW RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 SHADOW MOUNTAIN RD
TAOS NM
87571
US

IV. Provider business mailing address

30 PEMBROKE LN
LAGUNA NIGUEL CA
92677-9333
US

V. Phone/Fax

Practice location:
  • Phone: 210-480-1219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT J HOLUB
Title or Position: OWNER/FOUNDER
Credential:
Phone: 210-480-1219