Organization
MESCALERO CARE CENTER
Active
Other names
Mescalero Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MERLENE KAYDAHZINNE (ADMINISTRATOR)
(575) 464-4802
Entity
Organization
Contact information
Practice address
454 LIPAN AVE, MESCALERO, NM 88340
(505) 464-4802
(505) 464-4808
Mailing address
P.O. BOX 359, 454 LIPAN AVE, MESCALERO, NM 88340
(575) 464-4802
(575) 464-4808
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
3127
NM
314000000X
Skilled Nursing Facility
Primary
2026
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33531846
—
NM
05
—
67601081
—
NM
Enumeration date
06/08/2006
Last updated
11/27/2018
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