Organization
ENCHANTED LIVING OF NEW MEXICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DANIELLE DACOSTA (ADMINISTRATOR/CAREGIVER)
(505) 771-9098
Entity
Organization
Contact information
Practice address
6217 WILDFLOWER PASS NE, RIO RANCHO, NM 87144-6578
(505) 771-9098
Mailing address
6217 WILDFLOWER PASS NE, RIO RANCHO, NM 87144-6578
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1T2271
NM
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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