STATE OF NEW MEXICO

Nursing Facility/Intermediate Care Facility

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

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Contact Information

STATE OF NEW MEXICO

3695 HOT SPRINGS BLVD
LAS VEGAS, NM 87701-9549

Phone: 505-454-2100
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Nursing Facility/Intermediate Care Facility	313M00000X	A3[10]	Other Nursing Facility
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Psychiatric Hospital	283Q00000X	A0[7]	Hospital-Psychiatric (PPS excluded)
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X

Indicates primary specialty

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NPI Profile & details for STATE OF NEW MEXICO

NPI Number 1992867998

LBN Legal business name STATE OF NEW MEXICO

Authorized official CHARLES JARAMILLO - (CHIEF OPERATING OFFICER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 12/15/2006

Last updated 02/11/2015 - About 11 years ago

Identifiers

NM	License #	3035
NM	License #	5067
NM	License #	6011
NM	License #	7257
NM	Medicaid	50724
NM	Medicaid	96296
NM	Medicaid	I0126
NM	Medicaid	M1545
NM	Medicaid	NM600303

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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