Healthcare Provider Details

I. General information

NPI: 1922990431
Provider Name (Legal Business Name): FARMINGTON WELLNESS & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NELSON AVE
FARMINGTON NM
87401-3374
US

IV. Provider business mailing address

201 NELSON AVE
FARMINGTON NM
87401-3374
US

V. Phone/Fax

Practice location:
  • Phone: 505-675-4545
  • 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: DAVID GARETZ
Title or Position: CFO
Credential:
Phone: 213-395-1848