Healthcare Provider Details

I. General information

NPI: 1093341810
Provider Name (Legal Business Name): CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2020
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 WESTSIDE BLVD
RIO RANCHO NM
87124
US

IV. Provider business mailing address

5600 WYOMING BLVD NE STE 225
ALBUQUERQUE NM
87109-3136
US

V. Phone/Fax

Practice location:
  • Phone: 505-317-3802
  • Fax:
Mailing address:
  • Phone: 505-295-6358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: KRISTI DUNCAN
Title or Position: VP
Credential:
Phone: 505-317-3988