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General NPI Number Information
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NPI Number | 1982249363
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Entity Type | Organization
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Legal Business Name | RIVER CITY RECOVERY LLC
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Dates
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Enumeration Date | 11/09/2019
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1202 CENTRAL AVE SW STE 12
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2803
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Country | US
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Telephone | 505-414-6502
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Fax | 505-414-6502
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Provider Business Mailing Address
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Address Line | 1202 CENTRAL AVE SW STE 12
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2803
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Country | US
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Telephone | 505-414-6502
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Fax | 505-414-6502
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Authorized Official
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Title or Position | OWNER
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Name | IRENE VILLARREAL
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Credential | LMSW
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Telephone | 505-414-6502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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