Organization
STATE OF NEW MEXICO
Active
Parent organization
STATE OF NEW MEXICO
Other names
New Mexico State Veterans Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW MEXICO
Authorized official
KENNETH SHULL (HOSPITAL ADMINISTRATOR)
(575) 894-4216
Entity
Organization
Contact information
Practice address
992 S BROADWAY, TRUTH OR CONSEQUENCES, NM 87901-3198
(575) 894-4200
(575) 894-4291
Mailing address
992 S BROADWAY, TRUTH OR CONSEQUENCES, NM 87901-3198
(575) 894-4200
(575) 894-4291
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5087
NM
314000000X
Skilled Nursing Facility
5363
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
I0480
—
NM
Enumeration date
12/28/2005
Last updated
02/24/2025
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