OrganizationActive
Transitional Living Services
NPI 1285921569 · Mental Illness Community Based Residential Treatment Facility · Albuquerque, NM
Provider details
- NPI number
- 1285921569
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Gary Jackson, Executive Director(505) 268-5295
- License
- 105341 (NM)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
5601 Domingo Rd Ne
Albuquerque, NM 87108-1610
Phone: (505) 268-5295
Approximate (ZIP-level) locationGet directions
Mailing address
5601 Domingo Rd Ne
Albuquerque, NM 87108-1610
Registry dates
- Enumerated
- 2011-07-07
- Last updated
- 2011-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.