| NPI | 1124202304 |
|---|---|
| Doing Business As | RAVENSWOOD VILLAGE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WV 122) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2016-05-02 |