Provider Demographics
NPI:1811008618
Name:LAUREL HEALTHCARE LLC
Entity Type:Organization
Organization Name:LAUREL HEALTHCARE LLC
Other - Org Name:LAUREL VIEW HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMPINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-304-5152
Mailing Address - Street 1:5900 FOREST HILLS DRIVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4129
Mailing Address - Country:US
Mailing Address - Phone:505-822-6000
Mailing Address - Fax:505-822-6244
Practice Address - Street 1:5900 FOREST HILLS DRIVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4129
Practice Address - Country:US
Practice Address - Phone:505-822-6000
Practice Address - Fax:505-822-6244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5233314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
32D0534761OtherCLIA
NMI1585Medicaid
32D0534761OtherCLIA
1699967760Medicare Oscar/Certification
NMI1585Medicaid