Provider Demographics
NPI:1285840835
Name:SAHARA MOTEL N M INC
Entity Type:Organization
Organization Name:SAHARA MOTEL N M INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:XIAO
Authorized Official - Middle Name:MING
Authorized Official - Last Name:GONG
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:505-712-0239
Mailing Address - Street 1:5915 GIBSON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4835
Mailing Address - Country:US
Mailing Address - Phone:505-256-9803
Mailing Address - Fax:505-254-1395
Practice Address - Street 1:5915 GIBSON BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-4835
Practice Address - Country:US
Practice Address - Phone:505-256-9803
Practice Address - Fax:505-254-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM02493955002177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodgingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM177F00000XOtherLODGING