Healthcare Provider Details

I. General information

NPI: 1700353927
Provider Name (Legal Business Name): RATON CARE HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 HOSPITAL DR
RATON NM
87740-2022
US

IV. Provider business mailing address

5200 N PALM AVE STE 107
FRESNO CA
93704-2225
US

V. Phone/Fax

Practice location:
  • Phone: 575-445-2734
  • Fax: 575-445-8451
Mailing address:
  • Phone: 888-725-9186
  • 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: BRANDON BIGELOW
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 888-725-9186