| NPI | 1699957415 |
|---|---|
| Doing Business As | MEMORY SUPPORT OF HERITAGE HALL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL T BERG Asst Secretary 505-468-4742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MA 0875) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2020-10-23 |