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General NPI Number Information
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NPI Number | 1740192004
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Entity Type | Organization
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Legal Business Name | MT. MEDICAL CENTER AND REHAB
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 6211 4TH ST NW STE 1
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-5700
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Country | US
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Telephone | 888-983-5889
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Fax | 888-408-1009
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Provider Business Mailing Address
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Address Line | 6211 4TH ST NW STE 1
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-5700
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Country | US
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Telephone | 888-983-5889
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Fax | 888-408-1009
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Authorized Official
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Title or Position | OWNER/SCIENTIST
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Name | MR. INSLEY EVANS SR.
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Credential | CLS, MLS, MT, MLT
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Telephone | 503-475-9662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 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 #4
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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 #5
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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 #6
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 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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Taxonomy #8
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 364SH1100X
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Taxonomy Name | Holistic Clinical Nurse Specialist
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License Number |
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License Number State |
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