Organization · NPI-2

Assisted Living

Assisted Living Facility · El Paso, TX

NPI number1063993244
StatusActive
Last updated in NPPESAug 26, 2018

Details

NPI
1063993244
Entity type
Organization (NPI-2)
Legal business name
Assisted Living
Organization subpart
No
Enumeration date
Aug 24, 2018
Last updated
Aug 26, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility––Yes
174200000X Meals––

Other names

  • Miguel F. Leyva (Other Name)
  • Minerva Sustaita (Other Name)

Practice location

11065 Tom Weiskopf Dr
El Paso, TX 79936

Phone 915-694-6886

Mailing address

11065 Tom Weiskopf Dr
El Paso, TX 79936-3519

Phone 915-694-6886

Authorized official

Minerva Sustaita
Owner
9155195735

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