Healthcare Provider Details
I. General information
NPI: 1033280243
Provider Name (Legal Business Name): TOTAL CARE AT HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1706 N DAL PASO ST
HOBBS NM
88240-3041
US
IV. Provider business mailing address
PO BOX 5206
HOBBS NM
88241-5206
US
V. Phone/Fax
- Phone: 505-393-7997
- Fax: 505-393-7988
- Phone: 505-393-7997
- Fax: 505-393-7988
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 6507 |
| License Number State | NM |
VIII. Authorized Official
Name:
JAN
C.
PFEIFFER
Title or Position: PRESIDENT OF CORPORATION
Credential: R.N.
Phone: 505-393-7997