CASA ANGELICA (NPI# 1013067974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013067974 |
| Entity Type | Organization |
| Organization Name | CASA ANGELICA |
| Practice Address |
5629 Isleta Blvd Sw Albuquerque NM 87105-6623 |
| Practice Telephone | 5058775763 |
| Practice Fax Number | 5058732786 |
| Mailing Telephone | 5058775763 |
| Mailing Fax Number | 5058732786 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2008-07-09 |
| Authorized Official Name | MRS. LOUISE TURNER (ADMINISTRATOR) |
| Authorized Official Telephone | 5058775763 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 5118 | NM | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | M-0664 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CASA ANGELICA | 5629 Isleta Blvd Sw, Albuquerque, NM 87105-6623 |
| Street Address |
5629 ISLETA BLVD SW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87105-6623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278063 | Jacob Hill | Rehabilitation Practitioner | 2001-b El Centro Familiar Blvd Se, Albuqerque, NM 87105 | 2020-09-02 |
| 1083264824 | Kacie Rhodes | Technician | 515 Isleta Blvd Sw, Albuquerque, NM 87105 | 2019-09-13 |
| 1043870454 | Equal LLC | Assisted Living Facility | 207 Lagunitas Lane, Albuquerque, NM 87105 | 2019-06-18 |
| 1043792997 | Elizabeth Bennett | Counselor | 309 59th St Nw, Albuquerque, NM 87105 | 2018-09-06 |
| 1316439920 | Deann Nieto | Rehabilitation Practitioner | 2001b El Centro Familiar Blvd Sw, Albuquerque, NM 87105 | 2018-05-31 |
| 1487163457 | Karen Bejarano | Behavior Technician | 1847 Val Verde Rd Sw, Albuquerque, NM 87105 | 2017-09-21 |
| 1306360391 | Bendiciones Home Health Care | Home Health | 5500 Cleo Rd. Sw, Albuquerque, NM 87105 | 2017-08-01 |
| 1578927711 | Clarence Mills | Counselor | 1528 Five Points Rd Nw, Albuquerque, NM 87105 | 2016-04-13 |
| 1386024727 | Rachel Elaine Kadetz | Counselor | 1101 Lopez Rd. Sw, Albuquerque, NM 87105 | 2015-06-01 |
| 1598160772 | Sandra Jean Taylor | Lactation Consultant, Non-RN | 1305 Blake Rd Sw, Albuquerque, NM 87105 | 2014-10-30 |
| Find all providers in zip 87105 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750947420 | Great Livin II LLC | Intermediate Care Facility, Mentally Retarded | 4028 Mescalero Rd Ne, Albuquerque, NM 87110-1754 | 2019-05-17 |
| 1295870020 | Arca - Copper Home | Intermediate Care Facility, Mentally Retarded | 9101 Copper Ave Ne, Albuquerque, NM 87123-1007 | 2007-02-20 |
| 1720123565 | Arca - Gun Club | Intermediate Care Facility, Mentally Retarded | 2404 Gun Club Rd Sw, Albuquerque, NM 87105-6326 | 2007-02-20 |
| 1043355878 | Arca - Gibson Home | Intermediate Care Facility, Mentally Retarded | 5605 Gibson Blvd Se, Albuquerque, NM 87108-4831 | 2007-02-20 |
| 1336284165 | Arca - Trumbull | Intermediate Care Facility, Mentally Retarded | 7100 Trumbull Ave Se, Albuquerque, NM 87108-3984 | 2007-02-20 |
| 1134264971 | Arca - Louisiana | Intermediate Care Facility, Mentally Retarded | 615 Louisiana Blvd Se, Albuquerque, NM 87108-3844 | 2007-02-20 |
| 1740325588 | Arca - Park | Intermediate Care Facility, Mentally Retarded | 1120 Louisiana Blvd Se, Albuquerque, NM 87108-5009 | 2007-02-20 |
| 1275678005 | Arca - South Valley | Intermediate Care Facility, Mentally Retarded | 2206 El Centro Familiar Blvd Sw, Albuquerque, NM 87105-4555 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043688088 | Evershine Care, LLC | Intermediate Care Facility, Mentally Retarded | 4844 Calle Bella Ave, Las Cruces, NM 88012-7066 | 2015-09-08 |
| 1548474141 | New Horizons Casa Linda | Intermediate Care Facility, Mentally Retarded | 810 Avenue E, Carrizozo, NM 88301-0187 | 2007-05-10 |
| 1386773398 | Carc, Inc. | Intermediate Care Facility, Mentally Retarded | 902 W Cherry Ln, Carlsbad, NM 88220-8804 | 2007-03-05 |
| 1851428577 | Santa Maria El Mirador | Intermediate Care Facility, Mentally Retarded | 2041 S Pacheco St, Suite 100, Santa Fe, NM 87505-5473 | 2007-02-28 |
| 1992830012 | Arca - Corrales | Intermediate Care Facility, Mentally Retarded | 181 East La Entrada, Corrales, NM 87048 | 2007-02-22 |
| 1700948999 | New Horizons Developmental Ctr Inc | Intermediate Care Facility, Mentally Retarded | 810 E Ave, Carrizozo, NM 88301 | 2006-12-14 |
| 1124189048 | New Mexico Department of Health | Intermediate Care Facility, Mentally Retarded | 84 Estancia Road, Belen, NM 87002 | 2006-12-13 |
| 1801282983 | Carc, Inc. Orchard Home 3 | Intermediate Care Facility, Mentally Retarded | 902 W Cherry Ln, Carlsbad, NM 88220-8804 | 2015-04-15 |
| 1992191076 | Carc, Inc. Orchard Home 2 | Intermediate Care Facility, Mentally Retarded | 902 W Cherry Ln, Carlsbad, NM 88220-8804 | 2015-04-15 |
| 1710373899 | Carc, Inc. Orchard Home 4 | Intermediate Care Facility, Mentally Retarded | 902 W Cherry Ln, Carlsbad, NM 88220-8804 | 2015-04-15 |
| Find all providers with the same taxonomy | ||||
| City | ALBUQUERQUE |
| Zip Code | 87105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.