Healthcare Provider Details
I. General information
NPI: 1740092170
Provider Name (Legal Business Name): SANDIA SENIOR MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2025
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 SAN MATEO BLVD NE
ALBUQUERQUE NM
87108-1382
US
IV. Provider business mailing address
222 CAMINO DE LA TIERRA
CORRALES NM
87048-8562
US
V. Phone/Fax
- Phone: 505-382-4744
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 313M00000X |
| Taxonomy | Nursing Facility/Intermediate Care Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADRIAN
VALERIO
Title or Position: BUSINESS OFFICE
Credential:
Phone: 505-377-3829