Healthcare Provider Details

I. General information

NPI: 1477458362
Provider Name (Legal Business Name): MCKINNEY ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6104 MCKINNEY DR NE
ALBUQUERQUE NM
87109-3523
US

IV. Provider business mailing address

6104 MCKINNEY DR NE
ALBUQUERQUE NM
87109-3523
US

V. Phone/Fax

Practice location:
  • Phone: 505-322-2033
  • Fax: 505-254-4680
Mailing address:
  • Phone: 505-322-2033
  • Fax: 505-254-4680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: CONSUELO MESA DE BELTRAN
Title or Position: ADMINISTRATOR/MANAGING MEMBER
Credential:
Phone: 505-322-2033