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NPI Code Detail

MEDICARE: LAUREL MEADOWS LLC

MEDICARE: LAUREL MEADOWS 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
1314000000XSkilled Nursing Facility1044NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23200534490OTHERCLIA

General Provider Information

NPI Number : 1164531786
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAUREL MEADOWS LLC
Provider Business Mailing Address
First Line : 1831 CAMINO DEL LLANO
Second Line :
City : BELEN
State : NM
Zip : 87002-2619
Country : US
Telephone Number : 505-864-1600
Fax Number : 505-864-6923
Provider Business Practice Location Address
First Line : 1831 CAMINO DEL LLANO
Second Line :
City : BELEN
State : NM
Zip : 87002-2619
Country : US
Telephone Number : 505-864-1600
Fax Number : 505-864-6923
Authorized Official
Title or Position : MEMBER
Name : MR. ALAN ZAMPINI
Credential :
Telephone Number : 505-304-5152
Provider Enumeration Date : 08/29/2006
Last Update Date : 08/05/2008

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Directions to “LAUREL MEADOWS LLC ” Practice Location

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