Healthcare Provider Details

I. General information

NPI: 1235869850
Provider Name (Legal Business Name): CAREGIVERS OF NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/15/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 CAMINO DEL VALLE SW
ALBUQUERQUE NM
87105-6167
US

IV. Provider business mailing address

3925 CAMINO DEL VALLE SW
ALBUQUERQUE NM
87105-6167
US

V. Phone/Fax

Practice location:
  • Phone: 505-312-0697
  • Fax:
Mailing address:
  • Phone: 505-312-0697
  • 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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: APRIL FRAIRE
Title or Position: OWNER
Credential:
Phone: 505-312-0697