Provider Demographics
NPI:1184010266
Name:CARC, INC. ORCHARD HOME 1
Entity Type:Organization
Organization Name:CARC, INC. ORCHARD HOME 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHINNERER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-887-1570
Mailing Address - Street 1:PO BOX 1808
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88221-1808
Mailing Address - Country:US
Mailing Address - Phone:575-887-1570
Mailing Address - Fax:575-885-5135
Practice Address - Street 1:902 W CHERRY LN
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-8804
Practice Address - Country:US
Practice Address - Phone:575-887-1570
Practice Address - Fax:575-885-5135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1T3510315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities