LITTLE SISTERS OF THE POOR OF NEW MEXICO INC. NPI 1902022130

NPI Information

LITTLE SISTERS OF THE POOR OF NEW MEXICO, INC. is an assisted living facility in Gallup, NM. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. LITTLE SISTERS OF THE POOR OF NEW MEXICO, INC. NPI is 1902022130. The provider is registered as an organization entity type.
The provider Other Name Is Villa Guadalupe.

The provider's business location address is:

1900 MARK AVE
GALLUP, NM
ZIP 87301-822
Phone: (505) 863-6894
Fax: (505) 722-4121

The provider's authorized official is Mary Thomas D'mello .
The authorized official title is Director and has the following contact phone number (505) 863-6894.

The CLIA number assigned to this NPI record is 32D1064469 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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