# PEAK MEDICAL ROSWELL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PEAK MEDICAL, LLC
- **Other names:** Mission Arch Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1952355885
- **Legal business name:** PEAK MEDICAL, LLC
- **Authorized official:** MICHAEL BERG (ASSISTANT SECRETARY)
- **Authorized official phone:** (505) 468-4752

## Contact information

- **Practice address:** 3200 MISSION ARCH DR, ROSWELL, NM 88201-8307
- **Practice address phone:** (575) 624-2583
- **Mailing address:** 3200 MISSION ARCH DR, ROSWELL, NM 88201-8307
- **Mailing address phone:** (575) 624-2583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | 1035 | NM | — |
| 314000000X | Skilled Nursing Facility | 1035 | NM | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 03/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 62221001 | — | NM |