MEDICARE: DNHW, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	2235	NM

General Provider Information

NPI Number	:	1548684442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DNHW, LLC.

Provider Business Mailing Address
First Line	:	13170 CENTRAL AVE SE STE B204
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-5549
Country	:	US
Telephone Number	:	505-225-4435
Fax Number	:	505-819-5024

Provider Business Practice Location Address
First Line	:	2957 WISCONSIN ST NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-2457
Country	:	US
Telephone Number	:	505-225-4435
Fax Number	:	505-819-5024

Authorized Official
Title or Position	:	MEMBER
Name	:	HEATHER LAFONT
Credential	:
Telephone Number	:	505-225-4435

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	02/12/2014

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