Taos Recovery, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

5633 Issued in NM

Legal business name

TAOS RECOVERY, INC.

Doing business as

Vista Taos Renewal Center

Practice address

259 Blueberry Hill Rd
El Prado, NM 87529-7305

Phone

(575) 758-5858

NPI assigned

Jul 31, 2006

Last updated

May 2, 2019By 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

Mr. Blake Browder

Title

President

Phone

(575) 758-5858

Specialties & licenses 1

Addresses

Other names 1

• Vista Taos Renewal Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1790791697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 W HICKORY ST STE 201",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762014122",
            "telephone_number": "940-383-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 BLUEBERRY HILL RD",
            "city": "EL PRADO",
            "state": "NM",
            "postal_code": "875297305",
            "telephone_number": "575-758-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAOS RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "BROWDER",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-758-5858",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NM",
            "license": "5633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Taos Renewal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vista Taos Renewal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Irina Sels Campbell, LMT
• Noel Simmons
• Mary Adrienne Simonini, LISW
• John Smith, B.S. , D.O.M.
• Support 4 Healing
• Benjamin David Teitelbaum, DOM
• Andrea Terry, LPCC
• Cynthia Tollen
• Gina M Torres Balsamo, PA-C
• Transforming Perspectives LLC

• Substance Abuse Rehabilitation Facility in El Prado, NM
• Providers in El Prado, 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 May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.