| NPI | 1366613879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LEE SANDOVAL Director 505-934-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NM 5590) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |