Healthcare Provider Details

I. General information

NPI: 1972133924
Provider Name (Legal Business Name): CALIBRE POST ACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2029 SAGECREST AVE
LAS CRUCES NM
88011-8044
US

IV. Provider business mailing address

2029 SAGECREST AVE
LAS CRUCES NM
88011-8044
US

V. Phone/Fax

Practice location:
  • Phone: 818-522-4166
  • Fax:
Mailing address:
  • Phone: 818-522-4166
  • 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: MR. KENNETH GOLDBLATT
Title or Position: CEO
Credential:
Phone: 818-522-4166