# DIAMOND CARE VIDA ENCANTADA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vidan Encantada Nursing and Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467760892
- **Authorized official:** MR. HARVEY PELOVSKY (MANAGING PARTNER)
- **Authorized official phone:** (928) 978-0520

## Contact information

- **Practice address:** 2301 COLLINS DR, LAS VEGAS, NM 87701-4826
- **Practice address phone:** (505) 425-9362
- **Practice address fax:** (505) 425-8518
- **Mailing address:** 2301 COLLINS DR, LAS VEGAS, NM 87701-4826
- **Mailing address phone:** (505) 425-9362
- **Mailing address fax:** (505) 425-8518

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2010
- **Last updated:** 03/16/2015