Little Sisters of the Poor of New Mexico, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5119 Issued in NM

Legal business name

LITTLE SISTERS OF THE POOR OF NEW MEXICO, INC.

Practice address

1900 Mark Ave
Gallup, NM 87301-4822

Phone

(505) 863-6894

Fax

(505) 722-4121

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Mary Thomas D'Mello

Title

Director

Phone

(505) 863-6894

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Villa Guadalupe Other name

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

CLIA laboratory certificates

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902022130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MARK AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014822",
            "telephone_number": "505-863-6894",
            "fax_number": "505-722-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MARK AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014822",
            "telephone_number": "505-863-6894",
            "fax_number": "505-722-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE SISTERS OF THE POOR OF NEW MEXICO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "D'MELLO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-863-6894"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NM",
            "license": "5119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARC LICENSE #",
            "identifier": "5119",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Guadalupe",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeremy Taylor Lindsey, LMFT
• John Lockwood Lintelmann, RN
• Rebecca Linville, RN, BSN
• James R Lisko, M.D.
• Brittany Liszewski
• Cherri Littlechief, RN
• Evan Littlefish
• Constance Liu, MD
• Christine Viiginia Livingston, LMSW
• Gwendolyn Livingston

• Assisted Living Facility in Gallup, NM
• Providers in Gallup, NM by specialty
• Assisted Living 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.
• 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.