Healthcare Provider Details

I. General information

NPI: 1659425205
Provider Name (Legal Business Name): ATC HOMECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7309 SAN BENITO ST NW
ALBUQUERQUE NM
87120-3634
US

IV. Provider business mailing address

7309 SAN BENITO ST NW
ALBUQUERQUE NM
87120-3634
US

V. Phone/Fax

Practice location:
  • Phone: 505-831-1206
  • Fax: 505-833-0761
Mailing address:
  • Phone: 505-831-1206
  • Fax: 505-833-0761

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: MRS. CAROLYN S. HEDRINGTON
Title or Position: PRESIDENT
Credential:
Phone: 505-831-1206