| NPI | 1962787812 |
|---|---|
| Doing Business As | THE MEDICAL RESORT AT FIESTA PARK |
| Entity Type | Organization |
| Authorized Contact | ROBERT JEREMY MARTIN CEO 505-652-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2014-12-10 |