Provider Demographics
NPI:1093928434
Name:QUILTED CARE LTD. CO.
Entity Type:Organization
Organization Name:QUILTED CARE LTD. CO.
Other - Org Name:WESTWIND HOUSE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:WITT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:505-797-8735
Mailing Address - Street 1:5353 WYOMING BLVD NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3132
Mailing Address - Country:US
Mailing Address - Phone:505-797-8735
Mailing Address - Fax:505-797-9003
Practice Address - Street 1:6600 LOS VOLCANES RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-8424
Practice Address - Country:US
Practice Address - Phone:505-831-0002
Practice Address - Fax:505-831-2027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5831310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM54174015Medicaid