Organization
CASA DEL VALLE 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY LEE SANDOVAL (ADMINISTRATOR)
(505) 877-0275
Entity
Organization
Contact information
Practice address
2111 RAVEN LN SW, ALBUQUERQUE, NM 87105-4530
(505) 877-0275
(505) 877-1249
Mailing address
2111 RAVEN LN SW, ALBUQUERQUE, NM 87105-4530
(505) 877-0275
(505) 877-1249
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5280
NM
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
01/16/2015
Last updated
05/13/2024
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