- Enrollment id
- O20190702002333
- Enrollment state
- NM
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1700441243
- Multiple npi flag
- N
- Ccn
- 325057
- Associate id
- 0143554642
- Organization name
- LOVINGTON HEALTHCARE LLC
- Doing business as name
- LOVINGTON HEALTHCARE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LOVINGTON HEALTHCARE LLC
- Affiliation entity name
- OPCO SKILLED MANAGEMENT
- Affiliation entity id
- 773
- Address line 1
- 1600 W AVENUE I
- City
- LOVINGTON
- State
- NM
- Zip code
- 882605002