803 Hacienda Lane Opco, LLC
Organization Active NPI Skilled Nursing Facility · Bloomfield, NM
NPI 1255288593 · NPPES record last updated Mar 16, 2026
Key facts
- NPI
- 1255288593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 803 HACIENDA LANE OPCO, LLC
- Practice address
- 803 Hacienda LN
Bloomfield, NM 87413-5109 - Phone
- (323) 928-9445
- NPI assigned
- Mar 16, 2026
- Organization subpart
- No
Authorized official
- Name
- Avrohom Tress
- Title
- Executive Vice President
- Phone
- (323) 928-9445
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
803 Hacienda LN
Bloomfield, NM 87413-5109
Mailing address
9526 W Pico Blvd
Los Angeles, CA 90035-1202
Other providers in Bloomfield, NM
- 100 South Bloomfield Professional, LLC
- 803 Hacienda Lane Operations LLC
- Able Clinical Services Inc.
- Georgina G. Alby
- Angel Peak Counseling, LLC
- Elizabeth Applegate
All providers in Bloomfield, NM · Skilled Nursing 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 Mar 16, 2026. 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.