Healthcare Provider Details

I. General information

NPI: 1457986663
Provider Name (Legal Business Name): ALBUQUERQUE POST-ACUTE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 MACKLAND AVE NE
ALBUQUERQUE NM
87106-2018
US

IV. Provider business mailing address

3016 MACKLAND AVE NE
ALBUQUERQUE NM
87106-2018
US

V. Phone/Fax

Practice location:
  • Phone: 505-307-2585
  • Fax:
Mailing address:
  • Phone: 505-307-2585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. PERCY PENTECOST
Title or Position: OWNER
Credential: MD
Phone: 505-307-2585