Healthcare Provider Details

I. General information

NPI: 1861923864
Provider Name (Legal Business Name): LOVELACE UNM REHABILITATION HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692B SUITE 202 HOSPITAL DRIVE
SANTA FE NM
87505
US

IV. Provider business mailing address

1 BURTON HILLS BLVD SUITE 250
NASHVILLE TN
37215-6293
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-6399
  • Fax: 505-982-3219
Mailing address:
  • Phone: 615-296-3000
  • Fax: 615-296-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN C PETROVICH
Title or Position: E
Credential:
Phone: 615-296-3000