Healthcare Provider Details

I. General information

NPI: 1588580161
Provider Name (Legal Business Name): ABQ SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 SAN PEDRO DR NE
ALBUQUERQUE NM
87110-3397
US

IV. Provider business mailing address

2626 SAN PEDRO DR NE
ALBUQUERQUE NM
87110-3397
US

V. Phone/Fax

Practice location:
  • Phone: 505-456-6060
  • Fax: 505-431-1011
Mailing address:
  • Phone: 505-456-6060
  • Fax: 505-431-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANA MOLINA
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-545-3583