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General NPI Number Information
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NPI Number | 1649524950
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Entity Type | Organization
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Legal Business Name | MISSIONARY OF SISTERS OF THE BLESSED SACRAMENT - SBS INC
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 10801 LOMAS BLVD NE STE 101
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5401
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Country | US
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Telephone | 505-717-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 10801 LOMAS BLVD NE STE 101
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5401
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Country | US
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Telephone | 505-717-6453
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANGELA AKUAGBOGU
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Credential |
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Telephone | 505-717-6453
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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 | 3418
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License Number State | NM
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