Organization · Type 2 NPI

803 Hacienda Lane Opco, LLC

Skilled Nursing Facility · Bloomfield, NM

NPI number 1255288593 Active

Practice location

803 Hacienda Ln
Bloomfield, NM 87413-5109

Call (323) 928-9445 Map

Mailing address

9526 W Pico Blvd
Los Angeles, CA 90035-1202

Specialties and licenses

TaxonomyCodeLicense
Skilled Nursing Facility Primary 314000000XNone listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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About NPI 1255288593

803 Hacienda Lane Opco, LLC's National Provider Identifier is 1255288593, issued on Mar 16, 2026. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Bloomfield, NM. The record was last updated on Oct 20, 2026.