Healthcare Provider Details

I. General information

NPI: 1285431809
Provider Name (Legal Business Name): WASHINGTONS CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 CAGUA DR SE
ALBUQUERQUE NM
87108-3714
US

IV. Provider business mailing address

524 CAGUA DR SE
ALBUQUERQUE NM
87108-3714
US

V. Phone/Fax

Practice location:
  • Phone: 505-463-9283
  • Fax:
Mailing address:
  • Phone: 505-463-9283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COREY WASHINGTON
Title or Position: OWNER
Credential: LPN
Phone: 505-463-9283