Healthcare Provider Details

I. General information

NPI: 1275958647
Provider Name (Legal Business Name): DNHW, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 02/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 SOLANO DR NE
ALBUQUERQUE NM
87110-5629
US

IV. Provider business mailing address

13170 CENTRAL AVE SE STE B204
ALBUQUERQUE NM
87123-5549
US

V. Phone/Fax

Practice location:
  • Phone: 505-225-4435
  • Fax: 505-819-5024
Mailing address:
  • Phone: 505-225-4435
  • Fax: 505-819-5024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number2233
License Number StateNM

VIII. Authorized Official

Name: HEATHER LAFONT
Title or Position: MEMBER
Credential:
Phone: 505-225-4435