Thi of New Mexico at Sunset Villa, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THI OF NEW MEXICO AT SUNSET VILLA, LLC

Doing business as

Sunset Villa Care Center

Practice address

1515 S Sunset Ave
Roswell, NM 88203-2628

Phone

(505) 623-7097

Fax

(505) 624-1307

NPI assigned

Oct 7, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Buffy Itomitsu

Title

President

Phone

(505) 623-7097

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunset Villa Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1013004209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S SUNSET AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882032628",
            "telephone_number": "505-623-7097",
            "fax_number": "505-624-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF NEW MEXICO AT SUNSET VILLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "ITOMITSU",
        "authorized_official_first_name": "BUFFY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-623-7097"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87001055",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunset Villa Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Roswell, NM
• Providers in Roswell, NM by specialty
• Skilled Nursing Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.