Su Vida Services, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SU VIDA SERVICES, INC.

Practice address

3150 Carlisle Blvd NE
Suite #206
Albuquerque, NM 87110-1678

Phone

(505) 830-6045

NPI assigned

Apr 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vicki A. Miracle

Title

Treasure

Phone

(505) 830-6045

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174740856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CARLISLE BLVD NE",
            "address_2": "SUITE #206",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101678",
            "telephone_number": "505-830-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CARLISLE BLVD NE",
            "address_2": "SUITE #206",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101678",
            "telephone_number": "505-830-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SU VIDA SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIRACLE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "TREASURE",
        "authorized_official_telephone_number": "505-830-6045"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000D2601",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Sturdy, PT
• Michelle Sturgess
• Joy Beth Sturm, PA-C
• Suzzette Sturtevant, PHARMD
• Shannon Stuyvesant, PTA
• Sheila Su, RN
• Yong Yi Su, APRN-CNP
• Gerson Suarez Cedeno, M.D
• Cristina Suarez, PA-C
• Thomas Suarez

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.