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NPI Code Detail

MEDICARE: ARBOR CREEK LLC

MEDICARE: ARBOR CREEK 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 Facility1051NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13200535566OTHERCLIA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568571198
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARBOR CREEK LLC
Provider Business Mailing Address
First Line : 7900 CONSTITUTION AVENUE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-7513
Country : US
Telephone Number : 505-296-5565
Fax Number : 505-296-6659
Provider Business Practice Location Address
First Line : 7900 CONSTITUTION AVENUE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-7513
Country : US
Telephone Number : 505-296-5565
Fax Number : 505-296-6659
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 : 08/07/2008

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Directions to “ARBOR CREEK LLC ” Practice Location

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