NPI | 1538116116 |
---|---|
Doing Business As | EAGLE CREST |
Entity Type | Organization |
Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
Organization Subpart ? | Yes |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 030000017) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2016-01-14 |