Provider Demographics
NPI:1811769938
Name:MEANINGFUL RECOVERY OF NEW MEXICO, LLC
Entity type:Organization
Organization Name:MEANINGFUL RECOVERY OF NEW MEXICO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PREVENTIVE MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-550-6284
Mailing Address - Street 1:1503 UNIVERSITY BLVD NE STE 138
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1708
Mailing Address - Country:US
Mailing Address - Phone:505-243-2551
Mailing Address - Fax:505-243-0446
Practice Address - Street 1:1503 UNIVERSITY BLVD NE STE 138
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1708
Practice Address - Country:US
Practice Address - Phone:505-243-2551
Practice Address - Fax:505-243-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local