Organization
HACIENDAS AT GRACE VILLAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY COPPEDGE (CEO)
(575) 524-1020
Entity
Organization
Contact information
Practice address
2802 CORTE DIOS, LAS CRUCES, NM 88011-8140
(575) 524-1020
Mailing address
2802 CORTE DIOS, LAS CRUCES, NM 88011-8140
(575) 524-1020
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/11/2017
Last updated
07/21/2022
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