Healthcare Provider Details

I. General information

NPI: 1386045268
Provider Name (Legal Business Name): HOME MODIFICATION SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8516 CALLE ALAMEDA NE
ALBUQUERQUE NM
87113-1560
US

IV. Provider business mailing address

PO BOX 92978
ALBUQUERQUE NM
87199-2978
US

V. Phone/Fax

Practice location:
  • Phone: 505-341-9060
  • Fax:
Mailing address:
  • Phone: 505-341-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberBRC-2014-332244
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberFA0114064
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RICHARD DOWDICAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 505-341-9060