Organization
INNOVATIVE RECOVERY OF NEW MEXICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE KING LADAC (CEO)
(575) 522-2224
Entity
Organization
Contact information
Practice address
880 S TELSHOR BLVD STE 110, LAS CRUCES, NM 88011-8682
(575) 522-2224
(575) 208-7253
Mailing address
PO BOX 1078, LAS CRUCES, NM 88004-1078
(575) 522-2224
(575) 208-7253
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4878
NM
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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