Healthcare Provider Details

I. General information

NPI: 1346810165
Provider Name (Legal Business Name): RACHEL ANN HC, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4233 MONTGOMERY BLVD NE STE J200
ALBUQUERQUE NM
87109-6749
US

IV. Provider business mailing address

4233 MONTGOMERY BLVD NE STE 200
ALBUQUERQUE NM
87109-6707
US

V. Phone/Fax

Practice location:
  • Phone: 505-316-5440
  • Fax:
Mailing address:
  • Phone: 505-906-1170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. RACHEL WOMMACK
Title or Position: OWNER
Credential: RN
Phone: 505-906-1170