Healthcare Provider Details

I. General information

NPI: 1265097703
Provider Name (Legal Business Name): WHITE SANDS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 N LOVINGTON HWY
HOBBS NM
88240-9131
US

IV. Provider business mailing address

4601 WILSHIRE BLVD STE 220
LOS ANGELES CA
90010-3883
US

V. Phone/Fax

Practice location:
  • Phone: 575-392-6845
  • Fax:
Mailing address:
  • Phone: 323-405-3399
  • 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: SOLOMON GURWITZ
Title or Position: MANAGER
Credential:
Phone: 323-405-3399