Healthcare Provider Details

I. General information

NPI: 1124188024
Provider Name (Legal Business Name): SHARE YOUR CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 PAN AMERICAN FREEWAY, NE SUITE A
ALBUQUERQUE NM
87107
US

IV. Provider business mailing address

P.O. BOX 35101
ALBUQUERQUE NM
87176
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-1700
  • Fax: 505-298-1900
Mailing address:
  • Phone: 505-298-1700
  • Fax: 505-298-1900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICK PAVLAKOS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-298-1700