Organization
BROOKHAVEN NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA ARAGON (MANAGER OF OPERATIONS)
(505) 425-9304
Entity
Organization
Contact information
Practice address
813 4TH ST, LAS VEGAS, NM 87701-4422
(505) 425-9304
(505) 425-9305
Mailing address
813 4TH ST, LAS VEGAS, NM 87701-4422
(505) 425-9304
(505) 425-9305
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1048
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75509083
—
NM
Enumeration date
10/26/2005
Last updated
08/22/2020
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