| NPI | 1285253682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY T POLAND Manager, Provider Enrollment 505-923-5355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 275N00000X Medicare Defined Swing Bed Unit |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |