| NPI | 1356544787 |
|---|---|
| Other Name | JUANITA RIDDLE |
| Entity Type | Organization |
| Authorized Contact | JUANITA RIDDLE Owner 575-541-0551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NM IT2122) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NM #IT2107) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-08-11 |