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Organization

SENIOR CITIZEN RESIDENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VIRGINIA LOUISE SHONKWILER (ASSISTANT ADMINISTRATOR)
(575) 762-8052
Entity
Organization

Contact information

Practice address
2210 MARBY DRIVE, CLOVIS, NM 88101-8306
(575) 762-8052
(575) 769-1553
Mailing address
2210 MARBY DRIVE, CLOVIS, NM 88101-8306
(575) 762-8052
(575) 769-1553

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5539
NM

Other

Enumeration date
07/15/2008
Last updated
07/13/2011
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