Provider Demographics
NPI:1568870525
Name:CARE HOMES NM LLC
Entity Type:Organization
Organization Name:CARE HOMES NM LLC
Other - Org Name:RAVENNA ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-850-8720
Mailing Address - Street 1:3051 TWIN OAKS DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3191
Mailing Address - Country:US
Mailing Address - Phone:505-831-4141
Mailing Address - Fax:505-833-6066
Practice Address - Street 1:3051 TWIN OAKS DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3191
Practice Address - Country:US
Practice Address - Phone:505-831-4141
Practice Address - Fax:505-833-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2252310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility