Organization
EVERSHINE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN NNAMDI NWAOGU PHARMD (ADMINISTRATOR)
(575) 382-5973
Entity
Organization
Contact information
Practice address
4844 CALLE BELLA AVE, LAS CRUCES, NM 88012-7066
(575) 382-5973
Mailing address
4844 CALLE BELLA AVE, LAS CRUCES, NM 88012-7066
(575) 382-5973
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1T3533
NM
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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