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Contact Information

BROOKHAVEN NURSING HOME
813 4TH ST
LAS VEGAS, NM87701-4422
 Phone: 505-425-9304
 Fax: 505-425-9305
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for BROOKHAVEN NURSING HOME

NPI # 1043200454
LBN Legal business name BROOKHAVEN NURSING HOME
Authorized official VICTORIA ARAGON - (MANAGER OF OPERATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
NM License # 1048
NM Medicaid 75509083
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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