# LAUREL HEALTHCARE OF CLOVIS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Laurel Ridge Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003909987
- **Authorized official:** MR. ALAN ZAMPINI (MEMBER)
- **Authorized official phone:** (505) 304-5152

## Contact information

- **Practice address:** 1201 NORTH NORRIS STREET, CLOVIS, NM 88101-6371
- **Practice address phone:** (505) 762-3753
- **Practice address fax:** (505) 762-7566
- **Mailing address:** 1201 NORTH NORRIS STREET, CLOVIS, NM 88101-6371
- **Mailing address phone:** (505) 762-3753
- **Mailing address fax:** (505) 762-7566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1013 | NM | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 08/05/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 32D0700093 | CLIA | — |
| 05 | — | 97886262 | — | NM |