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Organization
CORONADO CARE CENTER LLC
Active
Organization
CORONADO CARE CENTER LLC
Active
Other names
Coronado Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GARETZ (CFO)
(323) 987-5954
Entity
Organization
Contact information
Practice address
1604 W 18TH ST, PORTALES, NM 88130-7097
(575) 359-4719
Mailing address
1604 W 18TH ST, PORTALES, NM 88130-7097
(575) 359-4719
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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