| NPI | 1912664236 |
|---|---|
| Doing Business As | MESA MANOR CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL THEODORE BERG Corporate Officer 505-468-4742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-22 |