Four Corners Detox Recovery

LBN: Santa Fe Recovery Center
Four Corners Detox Recovery is an health care organization with primary practice located at 2105 Hasler Valley Rd , Gallup NM 87305. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Group Psychotherapy, Agencies / Community/Behavioral Health, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Substance Abuse Rehabilitation Facility is the primary health care specialty. Santa Fe Recovery Center can be contacted via phone (505) 471-9856, or through Schleusener, Elisa via phone (505) 847-5422.

Contact Information

Primary practice address
2105 Hasler Valley Rd Gallup NM 87305
Phone: (505) 471-9856
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Schleusener, Elisa
Phone: (505) 847-5422

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X
Agencies / Community/Behavioral Health 251S00000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1033716972
LBN Legal business name Santa Fe Recovery Center
DBA Doing business as Four Corners Detox Recovery
Authorized official Schleusener, Elisa
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 5th, 2020
Last updated Jul 12th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033716972 NPPES
New Mexico MEDICAID 82536716

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