NPIMap

Organization Active NPI

Santa Fe Recovery Center Inc

  • Substance Abuse Rehabilitation Facility
  • Gallup, NM
National Provider Identifier
1033716972
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SANTA FE RECOVERY CENTER INC
Practice address
2105 Hasler Valley Rd
Gallup, NM 87301
Phone
(505) 471-9856
NPI assigned
Oct 5, 2020
Last updated
Mar 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SANTA FE RECOVERY CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elisa Schleusener
Title
Credentialing Manager
Phone
(505) 847-5422

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Community/Behavioral Health Agency 251S00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2105 Hasler Valley Rd
Gallup, NM 87301

Mailing address

2504 Camino Entrada
Santa Fe, NM 87507-4851
Phone (505) 471-4985

Other names 1

  • Four Corners Detox Recovery Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260422003040 NM Part B Supplier - Clinic/Group Practice 4385055417 Receives reassigned benefits from 2 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Gallup, NM

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2204795Santa Fe Recovery Center Inc2105 Hasler Valley Road, Gallup, NM 87301Certificate of waiverDec 9, 2026

National Provider Directory

National Provider Directory
Tax ID family
Santa Fe Recovery Center Inc10 organizations share this tax ID, including this one
Part of
Santa Fe Recovery Center Inc

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1033716972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 CAMINO ENTRADA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074851",
            "telephone_number": "505-471-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 HASLER VALLEY RD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-471-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA FE RECOVERY CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANTA FE RECOVERY CENTER INC",
        "enumeration_date": "2020-10-05",
        "last_updated": "2025-03-04",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "SCHLEUSENER",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "505-847-5422"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Corners Detox Recovery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.