Organization
MAROLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN W. RICKETTS (CFO)
(505) 796-3200
Entity
Organization
Contact information
Practice address
3801 ATRISCO DR., NW, ALBUQUERQUE, NM 87120-4903
(505) 839-9888
(505) 839-7787
Mailing address
3721 RUTLEDGE ROAD. NE, ALBUQUERQUE, NM 87109-5566
(505) 796-3200
(505) 796-3234
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
000D4636
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000D4636
—
NM
Enumeration date
12/20/2006
Last updated
03/19/2013
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