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General NPI Number Information
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NPI Number | 1023972080
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Entity Type | Organization
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Legal Business Name | BOSQUE TRAILS ASSISTED LIVING LLC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 4631 MI CORDELIA DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1849
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Country | US
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Telephone | 505-835-3834
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Fax | 505-557-1156
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Provider Business Mailing Address
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Address Line | 1500 MONTERREY RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-1584
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Country | US
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Telephone | 505-835-3834
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Fax | 505-557-1156
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Authorized Official
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Title or Position | OWNER
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Name | TRANON BASHTON
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Credential |
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Telephone | 505-835-3834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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