Provider Demographics
NPI:1043863483
Name:SANDIA VIEW SPAIN
Entity Type:Organization
Organization Name:SANDIA VIEW SPAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LYTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MRS
Authorized Official - Phone:505-681-3676
Mailing Address - Street 1:12501 ROYAL POINT CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7708
Mailing Address - Country:US
Mailing Address - Phone:605-681-3716
Mailing Address - Fax:844-437-2101
Practice Address - Street 1:12501 ROYAL POINT CT NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-7708
Practice Address - Country:US
Practice Address - Phone:605-681-3716
Practice Address - Fax:844-437-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness