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General NPI Number Information
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NPI Number | 1962930008
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Entity Type | Organization
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Legal Business Name | IHS RECOVERY PROGRAM, INC.
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 2000 SAINT MICHAELS DR STE 2
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City | SANTA FE
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State | NM
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Zip | 87505-7630
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Country | US
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Telephone | 505-983-1540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4144
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City | SANTA FE
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State | NM
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Zip | 87502-4144
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. BRIAN PARKHILL
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Credential | LPC, LADAC
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Telephone | 505-983-1540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0164191
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License Number State | NM
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