Healthcare Provider Details

I. General information

NPI: 1669038832
Provider Name (Legal Business Name): FARMINGTON HEALTH CARE CENTER LTD. CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SAGUARO TRL
FARMINGTON NM
87401-9632
US

IV. Provider business mailing address

2537 GOLDEN BEAR DR
CARROLLTON TX
75006-2377
US

V. Phone/Fax

Practice location:
  • Phone: 505-598-6000
  • Fax: 505-598-6009
Mailing address:
  • Phone: 212-954-4114
  • Fax: 214-880-0053

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: MS. ROBIN F UNDERHILL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 214-954-4114