| Revive Recovery Nm | |
|
2325 San Pedro Dr Ne Ste 2a Albuquerque NM 87110-4121 | |
| (505) 785-4737 | |
| Not Available |
| Full Name | Revive Recovery Nm |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2325 San Pedro Dr Ne Ste 2a, Albuquerque, New Mexico |
| Authorized Official Name and Position | Joseph G Vigil (OWNER) |
| Authorized Official Contact | 5057854737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Recovery Nm 12309 Conejo Rd Ne Albuquerque NM 87123-1517 Ph: (505) 785-4737 | Revive Recovery Nm 2325 San Pedro Dr Ne Ste 2a Albuquerque NM 87110-4121 Ph: (505) 785-4737 |
| NPI Number | 1700630050 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700630050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
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