Organization
SAGE ADDICTION TREATMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S SIMPSON CLINICAL PSYCHOLOGIS (DIRECTOR/CLINICAL PSYCHOLOGIST)
(505) 977-9180
Entity
Organization
Contact information
Practice address
2929 COORS BLVD NW STE 100D, ALBUQUERQUE, NM 87120-1272
(505) 977-9180
Mailing address
2929 COORS BLVD NW STE 100D, ALBUQUERQUE, NM 87120-1272
(505) 977-9180
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
0930
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518952662
—
NM
Enumeration date
09/12/2014
Last updated
09/12/2014
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