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Contact Information

GREAT LIVIN II LLC
4028 MESCALERO RD NE
ALBUQUERQUE, NM87110-1754
 Phone: 505-246-6971
 Fax: 505-247-2191
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intermediate Care Facility, Mentally Retarded

315P00000X
Indicates primary specialty

NPI Profile & details for GREAT LIVIN II LLC

NPI # 1750947420
LBN Legal business name GREAT LIVIN II LLC
Authorized official MATT POEL - (OWNER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/17/2019
Last updated 05/13/2024 - About 2 years ago
Identifiers
NM Medicaid 49852591
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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