Coronado Care Center LLC
Skilled Nursing Facility in Portales, NM. Organization (NPI-2).
NPI number1225754955
StatusActive
Last updated in NPPESOct 14, 2022
Details
- NPI
- 1225754955
- Entity type
- Organization (NPI-2)
- Legal business name
- Coronado Care Center LLC
- Organization subpart
- No
- Enumeration date
- Oct 14, 2022
- Certification date
- Oct 14, 2022
- Last updated
- Oct 14, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART A PROVIDER - SKILLED NURSING FACILITY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Other names
- Coronado Care Center (Doing Business As)
Practice location
1604 W 18th StPortales, NM 88130-7097
Phone 575-359-4719
Mailing address
1604 W 18th StPortales, NM 88130-7097
Phone 575-359-4719
Authorized official
David Garetz
Cfo
3239875954
Is something wrong?
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