Graceful Aging

LBN: Graceful Aging
Graceful Aging is an health care organization with primary practice located at 4402 Superstition Dr , Las Cruces NM 88011-7503. The organization recently has 3 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Phlebotomy, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is the primary health care specialty. Graceful Aging can be contacted via phone (575) 621-3390, or through Lopez, Amy Elise via phone (575) 621-3390.

Contact Information

Primary practice address
4402 Superstition Dr Las Cruces NM 88011-7503
Phone: (575) 621-3390
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lopez, Amy Elise DNP
Phone: (575) 621-3390

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Phlebotomy 246RP1900X
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X

Profile Details

NPI number 1053883306
LBN Legal business name Graceful Aging
DBA Doing business as
Authorized official Lopez, Amy Elise DNP
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2018
Last updated Aug 2nd, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053883306 NPPES
New Mexico MEDICAID 12431265

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