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General NPI Number Information
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NPI Number | 1740092170
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Entity Type | Organization
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Legal Business Name | SANDIA SENIOR MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 303 SAN MATEO BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-1382
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Country | US
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Telephone | 505-382-4744
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Fax |
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Provider Business Mailing Address
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Address Line | 222 CAMINO DE LA TIERRA
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City | CORRALES
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State | NM
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Zip | 87048-8562
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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 | OWNER
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Name | EDDIE LEIGHTON
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Credential |
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Telephone | 505-379-5232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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