| NPI | 1932156460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T BERG Assistant Secretary 505-468-4752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WV 94) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WV 94) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2018-08-17 |