Organization Name: | RECOVERY WORKS |
NPI Number: | 1427181205 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN K RUSSO (EXECUTIVE DIRECTOR) |
Mailing Address: | 36 State Rd. 522 #6 El Prado |
State: | NM US |
Postal Code: | 87529 |
Phone Number: | 5057379151 |
Fax Number: | 5057510846 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 08/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0088901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |