Organization
ANGEL WINGS ASSISTED LLVING HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETCHEN MARIE VALENCIA RN (OWNER)
(505) 610-1009
Entity
Organization
Contact information
Practice address
19 GARDEN PARK CIR NW, ALBUQUERQUE, NM 87107-2655
(505) 312-8674
Mailing address
19 GARDEN PARK CIR NW, ALBUQUERQUE, NM 87107-2655
(505) 610-1009
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2257
STATE LICENSE
NM
Enumeration date
12/13/2021
Last updated
12/13/2021
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