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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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