Provider Demographics
NPI:1427535251
Name:FULL CIRCLE RECOVERY
Entity Type:Organization
Organization Name:FULL CIRCLE RECOVERY
Other - Org Name:FULL CIRCLE RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:GARBERINA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-620-6891
Mailing Address - Street 1:3056 FRONTIER AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2037
Mailing Address - Country:US
Mailing Address - Phone:505-620-6891
Mailing Address - Fax:
Practice Address - Street 1:100 6TH ST S
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-4139
Practice Address - Country:US
Practice Address - Phone:505-865-4140
Practice Address - Fax:505-865-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility