| NPI | 1861846248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MD 10002) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 10002) |
| 225X00000X Occupational Therapist (Licence: MD 10002) | |
| 235Z00000X Speech-Language Pathologist (Licence: MD 10002) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2018-03-08 |