4210 Sabana Grande Avenue SE Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

4210 SABANA GRANDE AVENUE SE OPCO, LLC

Practice address

4210 Sabana Grande Ave SE
Rio Rancho, NM 87124-1152

Phone

(323) 928-9445

NPI assigned

Mar 16, 2026

Organization subpart

No

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

Authorized official

Name

Avrohom Tress

Title

Executive Vice President

Phone

(323) 928-9445

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1114875259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9526 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 SABANA GRANDE AVE SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241152",
            "telephone_number": "323-928-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4210 SABANA GRANDE AVENUE SE OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "TRESS",
        "authorized_official_first_name": "AVROHOM",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "323-928-9445"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Rio Rancho, NM
• Providers in Rio Rancho, 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 Mar 16, 2026; 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.