| NPI | 1003861899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MT 13066) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-05-17 |