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General NPI Number Information
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NPI Number | 1972223832
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Entity Type | Organization
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Legal Business Name | AMERICAN SAN PABLO, LLC
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1509 SAN PABLO ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7245
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Country | US
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Telephone | 505-254-9646
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Fax | 505-254-4630
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Provider Business Mailing Address
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Address Line | 1509 SAN PABLO ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7245
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Country | US
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Telephone | 505-254-9646
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Fax | 505-254-4630
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CONSUELO MESA DE BELTRAN
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Credential |
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Telephone | 505-730-7656
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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 |
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License Number State |
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