SOUTHWEST RECOVERY AND WELLNESS LLC (NPI# 1043713415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043713415 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST RECOVERY AND WELLNESS LLC |
| Practice Address |
3874 Masthead St Ne Albuquerque NM 87109-4479 |
| Mailing Address |
914 Pinehurst Rd Se Rio Rancho NM 87124-2219 |
| Practice Telephone | 5058969412 |
| Practice Fax Number | 5058952505 |
| Mailing Telephone | 3238548587 |
| Mailing Fax Number | 5058962505 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |
| Authorized Official Name | ROBERT D. MILLER (PRESIDENT) |
| Authorized Official Telephone | 3238548587 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 1568643146 | 05 |
| Street Address |
3874 MASTHEAD ST NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-4479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114361698 | Bitu Hemant Sheth | Physician Assistant | 3874 Masthead St Ne, Albuquerque, NM 87109-4479 | 2013-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609418144 | Pivot LLC | Family Medicine | 1620 Central Ave Se, Albuquerque, NM 87106-4411 | 2019-10-16 |
| 1689147365 | Stairway Recovery, LLC | Family Medicine | 6300 Riverside Plaza Ln Nw Ste 118 #96523, Albuquerque, NM 87120 | 2019-01-06 |
| 1629387261 | William Michael Shannon | Family Medicine | 100 John Dantis Dr, Albuquerque, NM 87151-0100 | 2010-09-30 |
| 1568478279 | Juliane Nichole Bohan | Family Medicine | 2600 Yale Blvd Se, Albuquerque, NM 87106-4217 | 2006-08-01 |
| 1205246667 | Recovery Services of Southern New Mexico LLC | Family Medicine | 1235 Wyoming Blvd Ne, Albuquerque, NM 87112-5044 | 2014-05-06 |
| 1124374004 | Julianne Austin | Family Medicine | 4201 Central Ave Nw, Suite K2, Albuquerque, NM 87105-1630 | 2012-07-30 |
| 1730470113 | Evan D Baldwin | Family Medicine | 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 | 2011-04-20 |
| 1184952061 | Joan Cecile Voute | Family Medicine | 1528 Five Points Rd Sw, Albuquerque, NM 87105-3014 | 2009-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639690050 | Ideal Option, Pllc | Family Medicine | 2019 Galisteo St Ste H1, Santa Fe, NM 87505-2106 | 2017-07-06 |
| 1306285820 | Alt Recovery Group LLC | Family Medicine | 1141 Mall Dr, Suite E, Las Cruces, NM 88011-8194 | 2013-06-18 |
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.