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General NPI Number Information
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NPI Number | 1962682450
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Entity Type | Organization
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Legal Business Name | CAREFREE ASSISTED LIVING
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 10916 JUAN TABO PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3987
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Country | US
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Telephone | 505-299-8000
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Fax | 505-299-8200
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Provider Business Mailing Address
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Address Line | 10916 JUAN TABO PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3987
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Country | US
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Telephone | 505-299-8000
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Fax | 505-299-8200
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Authorized Official
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Title or Position | RN
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Name | MRS. ESTEPHANIE JANE PETROPOULOS
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Credential | RN
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Telephone | 505-299-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 5647
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License Number State | NM
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