| NPI | 1891737573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Secretary 505-468-4752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MD 16-011) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: MD 16011) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2025-06-23 |