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General NPI Number Information
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NPI Number | 1093935959
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Entity Type | Organization
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Legal Business Name | ALL FAITHS
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1709 MOON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-3935
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Country | US
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Telephone | 505-271-0329
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Fax | 505-271-4957
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Provider Business Mailing Address
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Address Line | 2201 SAN PEDRO DR NE STE 210
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4133
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Country | US
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Telephone | 505-271-0329
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Fax | 505-271-4957
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | TASHA SIMMONS
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Credential |
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Telephone | 505-308-8342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number | M1099
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | M1099
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License Number State | NM
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Taxonomy #3
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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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