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General NPI Number Information
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NPI Number | 1174732838
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Entity Type | Organization
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Legal Business Name | COORDINATED SKILLED CARE, INC.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/21/2009
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Provider Practice Location Address
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Address Line | 200 N ARIZONA ST
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City | SILVER CITY
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State | NM
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Zip | 88061-4963
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Country | US
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Telephone | 505-538-0912
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Fax | 505-538-0917
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Provider Business Mailing Address
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Address Line | 205 W BOUTZ RD BLDG 6
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City | LAS CRUCES
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State | NM
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Zip | 88005-3259
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEN MEYERS
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Credential |
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Telephone | 505-524-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NM
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