# MASADA HOUSE INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922499136
- **Authorized official:** SHAWNA B RILEY BS LADAC (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (505) 325-9205

## Contact information

- **Practice address:** 610 N DUSTIN AVE, FARMINGTON, NM 87401
- **Practice address phone:** (505) 325-9205
- **Practice address fax:** (505) 325-9216
- **Mailing address:** 610 N DUSTIN AVE, FARMINGTON, NM 87401
- **Mailing address phone:** (505) 325-9205
- **Mailing address fax:** (505) 325-9216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 0154441 | NM | Yes |

## Other

- **Enumeration date:** 02/10/2015
- **Last updated:** 02/10/2015