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General NPI Number Information
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NPI Number | 1487907820
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Entity Type | Organization
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Legal Business Name | SF HEALTH FACILITIES - CASA REAL LP
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 1650 GALISTEO ST
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City | SANTA FE
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State | NM
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Zip | 87505-4747
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Country | US
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Telephone | 505-984-8313
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Fax | 505-984-2542
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Provider Business Mailing Address
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Address Line | 5420 W PLANO PKWY
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City | PLANO
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State | TX
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Zip | 75093-4823
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Country | US
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Telephone | 972-931-3800
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Fax | 972-767-6222
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | MRS. JAMIE L COLLIER
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Credential |
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Telephone | 972-931-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1088
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License Number State | NM
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