Organization
SHP VI ALBUQUERQUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FRESHWATER (AUTHORIZED OFFICIAL)
(520) 392-7624
Entity
Organization
Contact information
Practice address
6901 SAN VICENTE AVE NE, ALBUQUERQUE, NM 87109-2790
(505) 445-9200
Mailing address
6901 SAN VICENTE AVE NE, ALBUQUERQUE, NM 87109-2790
(505) 445-9200
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4113
NEW MEXICO DEPARTMENT OF HEALTH
NM
Enumeration date
02/01/2021
Last updated
01/19/2023
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