Thi of New Mexico at Vida Encantada, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THI OF NEW MEXICO AT VIDA ENCANTADA, LLC

Doing business as

Vida Encantada Nursing and Rehabilitation

Practice address

2301 Collins Dr
Las Vegas, NM 87701-4826

Phone

(505) 425-9362

Fax

(505) 425-3152

NPI assigned

Oct 7, 2006

Last updated

Mar 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sharon Inoue

Title

President

Phone

(505) 425-9362

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vida Encantada Nursing and Rehabilitation 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": "1205193600000",
    "number": "1467549659",
    "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": "2301 COLLINS DR",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014826",
            "telephone_number": "505-425-9362",
            "fax_number": "505-425-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF NEW MEXICO AT VIDA ENCANTADA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "INOUE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-425-9362"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72654899",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vida Encantada Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen H Taylor, D.D.S.
• Teambuilders Behavioral Health, LLC
• Teambuilders Behavioral Health, LLC
• Darla Rae Tenorio, LBSW
• Thi of New Mexico at En Su Casa LLC (En Su Casa Personal Care)
• Patria Thomas, L.P.C.C.
• Nancy Elizabeth Tisdel, LMHC
• Javier D Torres-Hughs, BMS
• Ivan Toya, CPSW
• Transition Health Services-Vida Encantada, LLC (Vida Encantada Nursing and Rehab)

• Skilled Nursing Facility in Las Vegas, NM
• Providers in Las Vegas, 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 11, 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.