Organization
WHEATFIELDS SENIOR LIVING
Active
Other names
Clovis Senior Living, LLC, Wheatfields Assisted Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL D. FISHER (PRESIDENT)
(775) 737-8906
Entity
Organization
Contact information
Practice address
4701 N. PRINCE STREET, CLOVIS, NM 88101
(575) 762-8700
(575) 762-8701
Mailing address
1701 SOUTH SUTRO TERRACE, CARSON CITY, NV 89706
(775) 468-6114
(775) 562-4757
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
T1 2191
NM
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46427261
—
NM
Enumeration date
06/11/2012
Last updated
04/11/2022
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