NPIMap

Organization Active NPI

Carlsbad Lifehouse Inc

  • Professional Counselor
  • Carlsbad, NM
National Provider Identifier
1467047977
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CARLSBAD LIFEHOUSE INC
Practice address
1900 Westridge Rd
Carlsbad, NM 88220-3550
Phone
(575) 725-5552
NPI assigned
Mar 5, 2021
Last updated
Dec 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary
Substance Abuse Rehabilitation Facility 324500000X NU

Addresses

Primary practice location

1900 Westridge Rd
Carlsbad, NM 88220-3550

Mailing address

PO Box 3141
Carlsbad, NM 88221-3141
Phone (575) 302-8304

Other practice location 1

106 N Mesquite St
Carlsbad, NM 88220-4960
Phone (575) 725-5552

Other identifiers 1

IdentifierTypeStateIssuer
2492137MedicaidNM

Other names 1

  • Carlsbad Life House Inc Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL computer Direct

National Provider Directory

National Provider Directory
Tax ID family
Carlsbad Lifehouse Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

614 W Stevens
Carlsbad, NM 88220

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1467047977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3141",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882213141",
            "telephone_number": "575-302-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WESTRIDGE RD",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203550",
            "telephone_number": "575-725-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 N Mesquite St",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "882204960",
            "country_code": "US",
            "telephone_number": "575-725-5552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARLSBAD LIFEHOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "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": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2492137",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "email",
            "address_1": "614 W. Stevens",
            "city": "Carlsbad",
            "state": "NM",
            "country_code": "US",
            "postal_code": "88220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Carlsbad Life House Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Carlsbad Life House Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.