Autumn Blessings Assistd Living, LLC
Organization Active NPI Assisted Living Facility · Logan, NM
NPI 1174675342 · NPPES record last updated Oct 14, 2009
Key facts
- NPI
- 1174675342
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- 5869 (NM)
- Legal business name
- AUTUMN BLESSINGS ASSISTD LIVING, LLC
- Practice address
- 400 Sunset
Logan, NM 88426-9681 - Phone
- (575) 487-2300
- Fax
- (575) 487-2302
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Ken D Willis
- Title
- Administrator
- Phone
- (575) 487-2300
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 5869 | NM | Yes |
Addresses
Primary practice location
400 Sunset
Logan, NM 88426-9681
Mailing address
400 Sunset
Logan, NM 88426-9681
Phone (575) 487-2300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000D3293 | Medicaid | NM |
Other names
- Autumn Blessings Assisted Living
Other providers in Logan, NM
- Abal, LCC
- Joyce Elaine Feerer
- Jenna Lindsay Gorman
- Logan Family Practice, LLC
- Sharon Darlene Oliver
- Village of Logan
All providers in Logan, NM · Assisted Living Facility in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.