Healthcare Provider Details

I. General information

NPI: 1144029943
Provider Name (Legal Business Name): ACCESS TO COMMUNITY RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 EUBANK BLVD SE APT 728
ALBUQUERQUE NM
87123-1972
US

IV. Provider business mailing address

PO BOX 3452
ALBUQUERQUE NM
87190-3452
US

V. Phone/Fax

Practice location:
  • Phone: 786-853-4584
  • Fax:
Mailing address:
  • Phone: 786-853-4584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MARITZA RUNK
Title or Position: CHW- OWNER
Credential:
Phone: 786-853-4584