Healthcare Provider Details

I. General information

NPI: 1871944470
Provider Name (Legal Business Name): OLIVAS SISTERS HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 OLD DENVER HWY
GLORIETA NM
87535-7047
US

IV. Provider business mailing address

484 OLD DENVER HWY
GLORIETA NM
87535-7047
US

V. Phone/Fax

Practice location:
  • Phone: 505-920-8121
  • Fax:
Mailing address:
  • Phone: 505-920-8121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIA GALINDO
Title or Position: PRESIDENT
Credential:
Phone: 505-920-8121