Organization
STATE OF NEW MEXICO
Active
Organization
STATE OF NEW MEXICO
Active
Parent organization
STATE OF NEW MEXICO
Other names
new mexico rehabilitation center
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW MEXICO
Authorized official
JOSE LUIS GURROLA (ADMINISTRATOR)
(575) 347-3410
Entity
Organization
Contact information
Practice address
72 GAIL HARRIS ST, ROSWELL, NM 88203-8116
(575) 347-3400
(575) 347-5177
Mailing address
72 GAIL HARRIS ST, ROSWELL, NM 88203-8116
(575) 347-3400
(575) 347-5177
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
6026
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0273
—
NM
Enumeration date
10/24/2017
Last updated
10/24/2017
Update your record
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