| NPI | 1508042797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDY J CHAVEZ Director 505-897-2322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: 89351321) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-01-17 |