VILLA GUADALUPE - NPI 1902022130 - Assisted Living Facility in Gallup, NM

Q: What is Little Sisters Of The Poor Of New Mexico, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

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About Villa Guadalupe NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VILLA GUADALUPE (NPI 1902022130) is a healthcare organization registered as an assisted living facility in Gallup, New Mexico and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through February 5, 2027 and lists Mary Thomas D'mello, Director, as its authorized official.

NPPES Registry Identity

NPI1902022130

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameLITTLE SISTERS OF THE POOR OF NEW MEXICO, INC.

Location Address1900 MARK AVEGallup, NM 87301-4822

Mailing Address1900 Mark AveGallup, NM 87301-4822 · (505) 863-6894 · Fax (505) 722-4121

Phone(505) 863-6894

Fax(505) 722-4121

Organization SubpartNo

Authorized OfficialMary Thomas D'melloDirector · (505) 863-6894

Enumeration DateApril 17, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1902022130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in NM · 5119

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1900 MARK AVE, Gallup, NM 87301

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Other Names 1

Other NameVilla Guadalupe

Other Identifiers 1

Other5119NM · Arc License #

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 32D1064469

Villa Guadalupe · Gallup, NM

Active · expires Feb 5, 2027

CLIA Number32D1064469

Laboratory TypeAssisted Living Facility

Certificate Effective DateFebruary 6, 2025

Certificate Expiration DateFebruary 5, 2027

Laboratory DirectorSr Theresa Louisa Woo Ching

Laboratory Phone(505) 863-6894

Laboratory LocationVilla Guadalupe1900 Mark Avenue, Gallup, NM 87301

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DHHS,PHS,NAIHS,GALLUP INDIAN MEDICAL CENTER

Assisted Living Facility

1900 MARK AVE
GALLUP, NM 87301

McKinley County (505) 722-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Little Sisters Of The Poor Of New Mexico, Inc.'s NPI number?

The NPI number for Little Sisters Of The Poor Of New Mexico, Inc. is 1902022130. It was assigned to this organization in the NPPES registry on April 17, 2007. The provider is also known as Villa Guadalupe.

Where is Little Sisters Of The Poor Of New Mexico, Inc. located?

Little Sisters Of The Poor Of New Mexico, Inc. is located at 1900 Mark Ave, Gallup, NM 87301. The listed phone number is (505) 863-6894.

What is Little Sisters Of The Poor Of New Mexico, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Little Sisters Of The Poor Of New Mexico, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 32D1064469) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Little Sisters Of The Poor Of New Mexico, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.