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General NPI Number Information
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NPI Number | 1700353927
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Entity Type | Organization
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Legal Business Name | RATON CARE HOLDINGS LLC
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 1660 HOSPITAL DR
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City | RATON
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State | NM
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Zip | 87740-2022
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Country | US
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Telephone | 575-445-2734
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Fax | 575-445-8451
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Provider Business Mailing Address
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Address Line | 5200 N PALM AVE STE 107
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City | FRESNO
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State | CA
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Zip | 93704-2225
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Country | US
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Telephone | 888-725-9186
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | BRANDON BIGELOW
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Credential |
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Telephone | 888-725-9186
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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 |
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License Number State |
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