Healthcare Provider Details

I. General information

NPI: 1700325677
Provider Name (Legal Business Name): LOVELACE UNM REHABILITATION HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 ELM ST NE
ALBUQUERQUE NM
87102
US

IV. Provider business mailing address

1 BURTON HILLS BLVD SUITE 250
NASHVILLE TN
37215-6293
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-4700
  • Fax: 505-727-4752
Mailing address:
  • Phone: 615-296-3000
  • Fax: 615-296-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN C PETROVICH
Title or Position: EVP
Credential:
Phone: 615-296-3000