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3720 Church Rock Street Operations LLC

Skilled Nursing Facility in Gallup, NM. Organization (NPI-2).

NPI number1356820419
StatusActive
Last updated in NPPESAug 9, 2018

Details

NPI
1356820419
Entity type
Organization (NPI-2)
Legal business name
3720 Church Rock Street Operations LLC
Organization subpart
No
Enumeration date
Aug 9, 2018
Last updated
Aug 9, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility––Yes

Other names

  • Red Rocks Care Center (Doing Business As)

Practice location

3720 Church Rock St
Gallup, NM 87301-4572

Phone 505-722-2261

Mailing address

101 E State St
Kennett Square, PA 19348-3109

Phone 610-925-2254

Authorized official

Michael Berg
Assistant Secretary
5054684742

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