Healthcare Provider Details

I. General information

NPI: 1043094055
Provider Name (Legal Business Name): BETTER LIFE ADULT LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 ROCKCRESS DR NW
ALBUQUERQUE NM
87120-4104
US

IV. Provider business mailing address

2929 COORS BLVD NW STE 201M
ALBUQUERQUE NM
87120-1279
US

V. Phone/Fax

Practice location:
  • Phone: 505-269-6930
  • Fax:
Mailing address:
  • Phone: 505-269-6930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DARYL BUTLER
Title or Position: PRESIDENT
Credential:
Phone: 505-269-6930