Healthcare Provider Details

I. General information

NPI: 1922524834
Provider Name (Legal Business Name): DJK HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 A MONTGOMERY BLVD NE SUITE A-101
ALBUQUERQUE NM
87109-1218
US

IV. Provider business mailing address

901 WATERFALL WAY STE 105
RICHARDSON TX
75080-6753
US

V. Phone/Fax

Practice location:
  • Phone: 505-881-0054
  • Fax: 808-551-0878
Mailing address:
  • Phone: 972-661-3737
  • Fax: 972-661-3721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNM

VIII. Authorized Official

Name: MRS. JENNIFER HADFIELD
Title or Position: CFO
Credential:
Phone: 214-244-2757