Provider Demographics
NPI:1982249363
Name:RIVER CITY RECOVERY LLC
Entity type:Organization
Organization Name:RIVER CITY RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:505-414-6502
Mailing Address - Street 1:1202 CENTRAL AVE SW STE 12
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2803
Mailing Address - Country:US
Mailing Address - Phone:505-414-6502
Mailing Address - Fax:505-414-6502
Practice Address - Street 1:1202 CENTRAL AVE SW STE 12
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2803
Practice Address - Country:US
Practice Address - Phone:505-414-6502
Practice Address - Fax:505-414-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-09
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency