| NPI | 1972500957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONRAD VAN BAALEN Executive Director 505-359-1978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NM 5061) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2025-12-11 |