Healthcare Provider Details

I. General information

NPI: 1154630796
Provider Name (Legal Business Name): NM CUIDADO CASERO HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2010
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 ANTHONY DR STE 3A
ANTHONY NM
88021-9331
US

IV. Provider business mailing address

1110 N CARROLL AVE
SOUTHLAKE TX
76092-5306
US

V. Phone/Fax

Practice location:
  • Phone: 575-882-3539
  • Fax: 575-882-2369
Mailing address:
  • Phone: 817-310-1100
  • Fax: 817-310-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CARMEN SANTIAGO
Title or Position: CEO
Credential:
Phone: 817-310-1100