Organization
STATE OF NEW MEXICO
Active
Parent organization
NEW MEXICO REHABILITATION CENTER
Other names
NEW MEXICO REHABILITATION CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW MEXICO REHABILITATION CENTER
Authorized official
MS. JANIE DAVIES (HOSPITAL ADMINISTRATOR)
(575) 347-3400
Entity
Organization
Contact information
Practice address
72 GAIL HARRIS AVE, ROSWELL, NM 88203-8116
(575) 347-3400
(575) 347-5177
Mailing address
72 GAIL HARRIS AVE, ROSWELL, NM 88203-8116
(575) 347-3400
(575) 347-5177
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
6026
NM
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
6026
NM
283X00000X
Rehabilitation Hospital
Primary
6026
NM
284300000X
Special Hospital
6026
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000273
—
NM
05
—
00049528
—
NM
05
—
28858735
—
NM
Enumeration date
09/26/2005
Last updated
01/21/2025
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