Organization Active NPI

South Valley Care Center, LLC

  • Nursing Facility/Intermediate Care Facility
  • Albuquerque, NM
National Provider Identifier
1124059084
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
APPLIED FOR Issued in NM
Legal business name
SOUTH VALLEY CARE CENTER, LLC
Practice address
1629 Bowe LN SW
Albuquerque, NM 87105-3772
Phone
(505) 877-2200
Fax
(505) 877-4654
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Hunter Greene
Title
Managing Member
Phone
(505) 450-5612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X APPLIED FOR NM Primary

Addresses

Primary practice location

1629 Bowe LN SW
Albuquerque, NM 87105-3772

Mailing address

2155 Louisiana Blvd NE
Suite 10200
Albuquerque, NM 87110-5409
Phone (505) 881-0979

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D0662614South Valley Care Center1629 Bowe Lane SW, Albuquerque, NM 87105Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

2155 Louisiana Blvd NE
Ste 10200
Albuquerque, NM 87110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124059084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 LOUISIANA BLVD NE",
            "address_2": "SUITE 10200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105409",
            "telephone_number": "505-881-0979",
            "fax_number": "505-881-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 BOWE LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053772",
            "telephone_number": "505-877-2200",
            "fax_number": "505-877-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH VALLEY CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "505-450-5612",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NM",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.