Healthcare Provider Details

I. General information

NPI: 1871410704
Provider Name (Legal Business Name): LOESH RIO RANCHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 19TH ST SE
RIO RANCHO NM
87124-4857
US

IV. Provider business mailing address

2410 19TH ST SE
RIO RANCHO NM
87124-4857
US

V. Phone/Fax

Practice location:
  • Phone: 385-342-5175
  • 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: ALICIA CEPEDA
Title or Position: SENIOR LEGAL/RISK MANAGER
Credential:
Phone: 385-342-5175