Healthcare Provider Details

I. General information

NPI: 1144975285
Provider Name (Legal Business Name): LUX HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2944 QUAIL POINTE DR NW
ALBUQUERQUE NM
87120-6180
US

IV. Provider business mailing address

2944 QUAIL POINTE DR NW
ALBUQUERQUE NM
87120-6180
US

V. Phone/Fax

Practice location:
  • Phone: 150-543-3079
  • Fax:
Mailing address:
  • Phone: 150-543-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH ULIBARRI
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 505-433-0794