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Organization

LAGUNA RAINBOW CORPORATION

Active
Other names
Laguna Rainbow Nursing Center
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARY KORETKE (DIRECTOR OF REIMBURSEMENT)
(303) 987-3088
Entity
Organization

Contact information

Practice address
I-40, EXIT 108, 1/2 MILE SOUTH STATE ROAD 23, CASA BLANCA, NM 87007-0490
(505) 552-6034
(505) 552-7645
Mailing address
PO BOX 490, CASA BLANCA, NM 87007-0490
(505) 552-6034
(505) 552-7645

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5063
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
I0365
NM
Enumeration date
01/11/2006
Last updated
03/07/2011
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