Organization
CORONADO CARE CENTER LLC
Active
Other names
Coronado Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GARETZ (CFO)
(323) 987-5954
Entity
Organization
Contact information
Practice address
1604 W 18TH ST, PORTALES, NM 88130-7097
(575) 359-4719
Mailing address
1604 W 18TH ST, PORTALES, NM 88130-7097
(575) 359-4719
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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