Organization
PEAK MEDICAL ASSISTED LIVING, LLC
Active
Parent organization
PEAK MEDICAL, LLC
Other names
The Village at Northrise-Desert Willow I
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEAK MEDICAL, LLC
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
2884 N ROADRUNNER PKWY, LAS CRUCES, NM 88011-0853
(575) 522-1110
Mailing address
2884 N ROADRUNNER PKWY, LAS CRUCES, NM 88011-0853
(575) 522-1110
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
5788
NM
311500000X
Alzheimer Center (Dementia Center)
5789
NM
314000000X
Skilled Nursing Facility
Primary
5841
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M156
BC/BS OF NM
NM
01
—
PROVA41670
MOLINA
NM
Enumeration date
05/27/2006
Last updated
11/27/2018
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