Healthcare Provider Details

I. General information

NPI: 1043182546
Provider Name (Legal Business Name): 1ST CARE AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 GEORGE RD SE UNIT 9282
ALBUQUERQUE NM
87106-5608
US

IV. Provider business mailing address

2100 GEORGE RD SE UNIT 9282
ALBUQUERQUE NM
87106-5608
US

V. Phone/Fax

Practice location:
  • Phone: 505-203-6518
  • Fax:
Mailing address:
  • Phone: 505-203-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRES CARLOS ROSALES
Title or Position: OFFICER
Credential:
Phone: 505-203-6518