| NPI | 1295124022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LEE SANDOVAL Administrator 505-877-0275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NM 5280) |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2024-05-13 |