Healthcare Provider Details

I. General information

NPI: 1093691784
Provider Name (Legal Business Name): ANOGHENA REHAB HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 KENT AVE NW STE B
ALBUQUERQUE NM
87102-3239
US

IV. Provider business mailing address

1123 KENT AVE NW STE B
ALBUQUERQUE NM
87102-3239
US

V. Phone/Fax

Practice location:
  • Phone: 505-306-8443
  • Fax:
Mailing address:
  • Phone: 505-306-8443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY IGBADUMHE
Title or Position: OWNER
Credential: MD
Phone: 505-306-8443