Active NPI
Epidaurus
Doing business as Amity Foundation
- Community/Behavioral Health Agency
- Albuquerque, NM
National Provider Identifier
1699869172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- EPIDAURUS
- Doing business as
- Amity Foundation
- Practice address
- 609 Gold Avenue SW
Albuquerque, NM 87102 - Phone
- (505) 246-9300
- Fax
- (505) 246-8905
- NPI assigned
- Oct 2, 2006
- Last updated
- Feb 9, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Rod G Mullen
- Title
- Ceo
- Phone
- (520) 749-7178
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
609 Gold Avenue SW
Albuquerque, NM 87102
Mailing address
PO Box 3043
Tucson, AZ 85702-3043
Phone (520) 622-6489
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94284267667 | Other | DUN |
Other names 1
- Amity Foundation
National Provider Directory
National Provider Directory- Tax ID family
- Amity Foundation
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Amity Foundation
- Substance Use Disorder Rehabilitation Clinic/Center
- Vista, CA
- NPI 1417434176
-
dba Amity Foundation
- Substance Use Disorder Rehabilitation Clinic/Center
- Tucson, AZ
- NPI 1831968551
-
dba Amity Foundation
- Substance Abuse Rehabilitation Facility
- Tucson, AZ
- NPI 1861505901
Locations
609 Gold Ave SW
Albuquerque, NM 87102
Phone (505) 246-9300
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Professional Counselor
- Albuquerque, NM
- NPI 1881193050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1454976000000",
"number": "1699869172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3043",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857023043",
"telephone_number": "520-622-6489",
"fax_number": "520-622-6490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 GOLD AVENUE SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87102",
"telephone_number": "505-246-9300",
"fax_number": "505-246-8905"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EPIDAURUS",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2016-02-09",
"status": "A",
"authorized_official_last_name": "MULLEN",
"authorized_official_first_name": "ROD",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "520-749-7178",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DUN",
"identifier": "94284267667",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Amity Foundation",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.