Expressions of Life

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

02-942112-00-8 Issued in NM

Legal business name

EXPRESSIONS OF LIFE

Practice address

3811 Atrisco Dr NW Ste C
Albuquerque, NM 87120-4903

Phone

(505) 831-6250

Fax

(505) 831-6254

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Carol Lynn Montoya-Herrera

Title

Director

Phone

(505) 831-6250

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649296252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 ATRISCO DR NW STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204903",
            "telephone_number": "505-831-6250",
            "fax_number": "505-831-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 ATRISCO DR NW STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204903",
            "telephone_number": "505-831-6250",
            "fax_number": "505-831-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESSIONS OF LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTOYA-HERRERA",
        "authorized_official_first_name": "CAROL LYNN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-831-6250"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NM",
            "license": "02-942112-00-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0413",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eye and Facial Surgery of NM
• Eye Associates of New Mexico LTD

• All providers in Albuquerque, NM
• Intellectual and/or Developmental Disabilities 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.