| Thunderbird Rising Recovery | |
|
1258 Ortiz Dr Se # 100 Albuquerque NM 87108-5592 | |
| (505) 463-1970 | |
| Not Available |
| Full Name | Thunderbird Rising Recovery |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1258 Ortiz Dr Se # 100, Albuquerque, New Mexico |
| Authorized Official Name and Position | Retta Lynn Riley (PROGRAM DIRECTOR) |
| Authorized Official Contact | 5054631970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thunderbird Rising Recovery 6704 Nueva Piedra St Nw Albuquerque NM 87120-3618 Ph: (505) 463-1970 | Thunderbird Rising Recovery 1258 Ortiz Dr Se # 100 Albuquerque NM 87108-5592 Ph: (505) 463-1970 |
| NPI Number | 1043755002 |
|---|---|
| Provider Enumeration Date | 12/30/2016 |
| Last Update Date | 07/30/2021 |
| Certification Date | 07/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043755002 | NPI | - | NPPES |
| 80273521 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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