Healthcare Provider Details

I. General information

NPI: 1992829527
Provider Name (Legal Business Name): HEART 2 HEART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 COORS BLVD NW SUITE 201M
ALBUQUERQUE NM
87120-1173
US

IV. Provider business mailing address

2929 COORS BLVD NW SUITE 201M
ALBUQUERQUE NM
87120-1173
US

V. Phone/Fax

Practice location:
  • Phone: 505-944-2917
  • Fax: 505-944-2919
Mailing address:
  • Phone: 505-944-2917
  • Fax: 505-944-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberFA0052786
License Number StateNM

VIII. Authorized Official

Name: MRS. JESSICA M MARTINEZ
Title or Position: OWNER
Credential:
Phone: 505-944-2917