Casa Angelica

NPI 1013067974 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1013067974
Enumeration Date 01/11/2007
Last Updated 07/09/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LOUISE LOUISE
Position ADMINISTRATOR
Phone (505) 877-5763
Fax (505) 873-2786
Practice Location
5629 ISLETA BLVD SW
ALBUQUERQUE NM, 87105-6623, US
Phone (505) 877-5763
Fax (505) 873-2786
Business Location
5629 ISLETA BLVD SW
ALBUQUERQUE NM, 87105-6623, US
Phone (505) 877-5763
Fax (505) 873-2786
Toxanomy
Taxonomy Code 315P00000X
License State New Mexico
License Number 5118
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According to our database, Casa Angelica NPI is 1013067974, taxonomy code is 315P00000X and license number is 5118, license state is located at New Mexico. Casa Angelica physically located at 5629 Isleta Blvd Sw, Albuquerque NM, 87105-6623. NPI Number 1033115704 has the healthcare provider type.

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1013067974 NPI number is provided on an as is basis without warranty of any kind. 1013067974 is maintained by the National Plan & Provider Enumeration System. The contents of Casa Angelica are for informational purposes only.