Healthcare Provider Details

I. General information

NPI: 1558068205
Provider Name (Legal Business Name): SOL AMOR SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4273 MONTGOMERY BLVD NE STE 110
ALBUQUERQUE NM
87109-6746
US

IV. Provider business mailing address

4273 MONTGOMERY BLVD NE STE 110
ALBUQUERQUE NM
87109-6746
US

V. Phone/Fax

Practice location:
  • Phone: 505-365-1302
  • Fax: 505-520-0131
Mailing address:
  • Phone: 505-365-1302
  • Fax: 505-520-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DENISE IRWIN-PODLESNY
Title or Position: CEO
Credential: RN
Phone: 505-365-1302