Organization
CASA ANGELICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOUISE TURNER (ADMINISTRATOR)
(505) 877-5763
Entity
Organization
Contact information
Practice address
5629 ISLETA BLVD SW, ALBUQUERQUE, NM 87105-6623
(505) 877-5763
(505) 873-2786
Mailing address
5629 ISLETA BLVD SW, ALBUQUERQUE, NM 87105-6623
(505) 877-5763
(505) 873-2786
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5118
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M-0664
—
NM
Enumeration date
01/11/2007
Last updated
07/09/2008
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