Healthcare Provider Details

I. General information

NPI: 1174328694
Provider Name (Legal Business Name): M & N COMPASSIONATE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 SILVER AVE SW
ALBUQUERQUE NM
87102-3123
US

IV. Provider business mailing address

312 GENTLE STREAM LN
RALEIGH NC
27603-4868
US

V. Phone/Fax

Practice location:
  • Phone: 480-298-7141
  • Fax:
Mailing address:
  • Phone: 480-298-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: AMY DAVIS
Title or Position: DIRECTOR
Credential:
Phone: 480-298-7141