Organization · Type 2 NPI

City of Laredo

Substance Abuse Rehabilitation Facility · Laredo, TX

NPI number 1952174419 Active

Practice location

1300 Chicago St., Suite 101
Laredo, TX 78040

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center	261QM1300X	None listed
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

NPI record

NPI: 1952174419
Entity type: Organization (Type 2)
Issued: Nov 6, 2023
Last updated: Jun 12, 2024
Status: Active
Subpart: Yes of City of Laredo

Other names

<unavail>
City of Laredo Detox Center · doing business as
Roots Recovery Center · doing business as

Authorized official

Dr. San Juana Viviana Martinez, PhD, DHA, LCDC
Detoxification Director
(956) 679-2826

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1952174419

City of Laredo's National Provider Identifier is 1952174419, issued on Nov 6, 2023. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Laredo, TX. The record was last updated on Jun 12, 2024.