NPIMap

Organization Active NPI

Sequel of New Mexico, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Albuquerque, NM
National Provider Identifier
1992944557
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
2020 Issued in NM
Legal business name
SEQUEL OF NEW MEXICO, LLC
Practice address
1801 Randolph Rd SE
Albuquerque, NM 87106-4230
Phone
(505) 924-6330
Fax
(505) 768-7956
NPI assigned
Feb 5, 2009
Organization subpart
Yes
Parent organization
SEQUET YOUTH AND FAMILY SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Authorized official

Name
Yvonne R Gurule
Title
Director of Marketing & Contracts
Phone
(505) 710-9210

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 2020 NM Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 2021 NM
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 2022 NM

Addresses

Primary practice location

1801 Randolph Rd SE
Albuquerque, NM 87106-4230

Mailing address

5400 Gibson Blvd., SE
Suite 'a'
Albuquerque, NM 87108
Phone (505) 924-6330

Other identifiers 1

IdentifierTypeStateIssuer
NM#96128259MedicaidNM

National Provider Directory

National Provider Directory

Locations

5400 Gibson Blvd SE
Ste A
Albuquerque, NM 87108
Phone (505) 924-6350

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519084800000",
    "number": "1992944557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD., SE",
            "address_2": "SUITE 'A'",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-924-6330",
            "fax_number": "505-768-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 RANDOLPH RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064230",
            "telephone_number": "505-924-6330",
            "fax_number": "505-768-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL OF NEW MEXICO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUET YOUTH AND FAMILY SERVICES, LLC",
        "enumeration_date": "2009-02-05",
        "last_updated": "2018-02-20",
        "status": "A",
        "authorized_official_last_name": "GURULE",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF MARKETING &  CONTRACTS",
        "authorized_official_telephone_number": "505-710-9210"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NM",
            "license": "2020",
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NM",
            "license": "2021",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NM",
            "license": "2022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NM#96128259",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 20, 2018; 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.