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NPI Code Detail

MEDICARE: SANTA FE RECOVERY CENTER INC

MEDICARE: SANTA FE RECOVERY CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2251S00000XCommunity/Behavioral Health Agency
3324500000XSubstance Abuse Rehabilitation Facility5382NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447265160
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANTA FE RECOVERY CENTER INC
Provider Business Mailing Address
First Line : 2504 CAMINO ENTRADA
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4851
Country : US
Telephone Number : 505-471-4985
Fax Number : 505-471-6084
Provider Business Practice Location Address
First Line : 2504 CAMINO ENTRADA
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4851
Country : US
Telephone Number : 505-471-4985
Fax Number : 505-471-6084
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : ELISA SCHLEUSENER
Credential :
Telephone Number : 505-847-5422
Provider Enumeration Date : 07/30/2006
Last Update Date : 06/20/2025

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1114094547 — PRESBYTERIAN MEDICAL SERVICES
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Directions to “SANTA FE RECOVERY CENTER INC ” Practice Location

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