Avalon Ranch

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

AVALON RANCH

Practice address

106 N Mesquite St
Carlsbad, NM 88220-4960

Phone

(575) 302-8304

NPI assigned

Feb 10, 2021

Last updated

Feb 10, 2021By 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

Kimberly Susan Rogge-Rogers

Title

Executive Director

Phone

(575) 302-8304

Specialties & licenses 1

Addresses

Other names 1

• Avalon Ranch Former legal business name

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1265024103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N MESQUITE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204960",
            "telephone_number": "575-302-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N MESQUITE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204960",
            "telephone_number": "575-302-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "ROGGE-ROGERS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "575-302-8304"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Ranch",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• Substance Abuse Rehabilitation Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.