MEDICARE: BOSQUE TRAILS ASSISTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1023972080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSQUE TRAILS ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	1500 MONTERREY RD NE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87144-1584
Country	:	US
Telephone Number	:	505-835-3834
Fax Number	:	505-557-1156

Provider Business Practice Location Address
First Line	:	4631 MI CORDELIA DR NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-1849
Country	:	US
Telephone Number	:	505-835-3834
Fax Number	:	505-557-1156

Authorized Official
Title or Position	:	OWNER
Name	:	TRANON BASHTON
Credential	:
Telephone Number	:	505-835-3834

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “BOSQUE TRAILS ASSISTED LIVING LLC ” Practice Location

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