803 Hacienda Lane Operations LLC
NPI 1134607690ActiveOrganization· Skilled Nursing Facility· Bloomfield, NM
Skilled Nursing Facility in Bloomfield, New Mexico, registered in NPPES in August 2018. The authorized official on file is Michael Berg, Assistant Secretary. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1134607690 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 6, 2018 |
| Last updated in NPPES | Aug 6, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | NM |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (NM) |
|---|
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