Healthcare Provider Details

I. General information

NPI: 1740788421
Provider Name (Legal Business Name): VETERAN'S HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 JEMEZ DAM RD STE 110
BERNALILLO NM
87004-5986
US

IV. Provider business mailing address

51 JEMEZ DAM RD STE 110
BERNALILLO NM
87004-5986
US

V. Phone/Fax

Practice location:
  • Phone: 505-867-5372
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: PENNY EMERSON
Title or Position: OWNER
Credential:
Phone: 505-867-5372