MEDICARE: SUNFLOWER OF NEW MEXICO ADULT DAY HAB

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1821425745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNFLOWER OF NEW MEXICO ADULT DAY HAB

Provider Business Mailing Address
First Line	:	605 E LOHMAN AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-3374
Country	:	US
Telephone Number	:	575-524-0615
Fax Number	:	575-524-1406

Provider Business Practice Location Address
First Line	:	605 E LOHMAN AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-3374
Country	:	US
Telephone Number	:	575-524-0615
Fax Number	:	575-524-1406

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RAMON A TORRES
Credential	:	MHA
Telephone Number	:	575-524-0615

Provider Enumeration Date	:	10/09/2013
Last Update Date	:	10/09/2013

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