Organization
THI OF NEW MEXICO AT SUNSET VILLA, LLC
Active
Other names
Sunset Villa Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BUFFY ITOMITSU (PRESIDENT)
(505) 623-7097
Entity
Organization
Contact information
Practice address
1515 S SUNSET AVE, ROSWELL, NM 88203-2628
(505) 623-7097
(505) 624-1307
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87001055
—
NM
Enumeration date
10/07/2006
Last updated
04/08/2008
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