Provider Demographics
NPI:1629260781
Name:ALBUQUERQUE HEIGHTS HEALTHCARE AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:ALBUQUERQUE HEIGHTS HEALTHCARE AND REHABILITATION CENTER, LLC
Other - Org Name:ALBUQUERQUE HEIGHTS HEALTHCARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-468-4752
Mailing Address - Street 1:103 HOSPITAL LOOP NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-2115
Mailing Address - Country:US
Mailing Address - Phone:505-348-8300
Mailing Address - Fax:505-348-8270
Practice Address - Street 1:103 HOSPITAL LOOP NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2115
Practice Address - Country:US
Practice Address - Phone:505-348-8300
Practice Address - Fax:505-348-8270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-13
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1069314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM325069Medicare Oscar/Certification