Organization
CASA DE SHALOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM STANLEY (DIRECTOR)
(505) 715-9649
Entity
Organization
Contact information
Practice address
604 GRAL TREVINO DR SE, RIO RANCHO, NM 87124-1271
(505) 715-9649
Mailing address
604 GRAL TREVINO DR. SE, RIO RANCHO, NM 87124
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2164
NM
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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