Healthcare Provider Details

I. General information

NPI: 1487907820
Provider Name (Legal Business Name): SF HEALTH FACILITIES - CASA REAL LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GALISTEO ST
SANTA FE NM
87505-4747
US

IV. Provider business mailing address

5420 W PLANO PKWY
PLANO TX
75093-4823
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-8313
  • Fax: 505-984-2542
Mailing address:
  • Phone: 972-931-3800
  • Fax: 972-767-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1088
License Number StateNM

VIII. Authorized Official

Name: MRS. JAMIE L COLLIER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 972-931-3800