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General NPI Number Information
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NPI Number | 1093670812
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE REENTRY SERVICES
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 1605 JUAN TABO BLVD NE STE U
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-4459
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Country | US
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Telephone | 505-712-0170
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Fax |
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Provider Business Mailing Address
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Address Line | 521 DOROTHY ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-2818
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Country | US
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Telephone | 505-810-6370
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Fax | 505-810-6370
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANDREW J MILLER
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Credential | CCSS
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Telephone | 505-810-6370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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