NPIMap

Organization Active NPI

Rio Grande Alcoholism Treatment Center Incorporated

  • Substance Abuse Rehabilitation Facility
  • Taos, NM
National Provider Identifier
1194924928
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED
Practice address
105 Paseo del Canon W Ste a
Taos, NM 87571-6943
Phone
(575) 737-5533
Fax
(575) 737-5534
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Authorized official

Name
Mr. Lawrence Medina
Title
Executive Director
Phone
(575) 737-5533

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 5517 NM
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

105 Paseo del Canon W Ste a
Taos, NM 87571-6943

Mailing address

105 Paseo del Canon W Ste a
Taos, NM 87571-6943
Phone (575) 737-5533

Other practice location 1

2301 7th St Ste A
Las Vegas, NM 87701-4966
Phone (505) 454-9611

Other practice location 2

220 Albright St
Taos, NM 87571-6312
Phone (575) 213-6002

Other identifiers 1

IdentifierTypeStateIssuer
83774556MedicaidNM

Other names 1

  • Rio Grande Alcoholism Treatment Program, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210518002343 NM Part B Supplier - Clinic/Group Practice 3476952771 Receives reassigned benefits from 5 practitioners
Practice locations: Taos, NM; Las Vegas, NM

National Provider Directory

National Provider Directory

Locations

2100 7th St
Las Vegas, NM 87701
Phone (505) 454-9611

2301 7th St
#A
Las Vegas, NM 87701
Phone (505) 454-8079

220 Albright St
Taos, NM 87571
Phone (575) 213-6002

105 Paseo del Canon W
Ste A
Taos, NM 87571
Phone (575) 737-5533

224 Cruz Alta Rd
Ste J
Taos, NM 87571
Phone (575) 737-5533

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741478400000",
    "number": "1194924928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PASEO DEL CANON W STE A",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716943",
            "telephone_number": "575-737-5533",
            "fax_number": "575-737-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PASEO DEL CANON W STE A",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716943",
            "telephone_number": "575-737-5533",
            "fax_number": "575-737-5534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 7th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877014966",
            "country_code": "US",
            "telephone_number": "505-454-9611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Albright St",
            "address_purpose": "LOCATION",
            "city": "Taos",
            "state": "NM",
            "postal_code": "875716312",
            "country_code": "US",
            "telephone_number": "575-213-6002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIO GRANDE ALCOHOLISM TREATMENT CENTER INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "575-737-5533",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NM",
            "license": "5517",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83774556",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rio Grande Alcoholism Treatment Program, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.