Organization
SENIOR COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J STODDARD (OWNER/PRESIDENT)
(575) 763-8100
Entity
Organization
Contact information
Practice address
200 MURRAY DR, CLOVIS, NM 88101-4349
(505) 799-6162
Mailing address
1148 BLUE HOLE RD, SANTA ROSA, NM 88435-2546
(575) 472-2000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2157
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92137822
—
NM
Enumeration date
09/04/2009
Last updated
09/04/2009
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