Healthcare Provider Details

I. General information

NPI: 1770113722
Provider Name (Legal Business Name): ARTESIA HEALTHCARE & REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 W GILCHRIST AVE
ARTESIA NM
88210-1134
US

IV. Provider business mailing address

1402 W GILCHRIST AVE
ARTESIA NM
88210-1134
US

V. Phone/Fax

Practice location:
  • Phone: 575-746-6006
  • Fax:
Mailing address:
  • Phone: 575-746-6006
  • 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: KENNETH GOLDBLATT
Title or Position: CEO
Credential:
Phone: 818-522-4166