Silverstone Healthcare of Espanola Valley, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1028 Issued in NM

Legal business name

SILVERSTONE HEALTHCARE OF ESPANOLA VALLEY, LLC

Doing business as

Espanola Valley Nursing & Rehab

Practice address

720 E Hacienda St
Espanola, NM 87532-2523

Phone

(505) 753-6769

Fax

(505) 747-1589

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

William A. Mathies

Title

President/Director

Phone

(505) 821-3355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Espanola Valley Nursing & Rehab Doing business as

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639125669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E HACIENDA ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322523",
            "telephone_number": "505-753-6769",
            "fax_number": "505-747-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERSTONE HEALTHCARE OF ESPANOLA VALLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NM",
            "license": "1028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16374223",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Espanola Valley Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Espanola, NM
• Providers in Espanola, 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 Aug 22, 2020; 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.