Healthcare Provider Details

I. General information

NPI: 1619447554
Provider Name (Legal Business Name): ALBUQUERQUE OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 HORIZON BLVD NE # NA
ALBUQUERQUE NM
87113-1689
US

IV. Provider business mailing address

25117 SW PARKWAY AVE STE F
WILSONVILLE OR
97070-9697
US

V. Phone/Fax

Practice location:
  • Phone: 505-998-1551
  • Fax:
Mailing address:
  • Phone:
  • 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: CHRIS OLSON
Title or Position: SENIOR PARALEGAL
Credential:
Phone: 503-570-3405