Healthcare Provider Details

I. General information

NPI: 1003201526
Provider Name (Legal Business Name): SANTA FE HOME CARE OF NEW MEXICO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 12/10/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WYATT DR STE A
LAS CRUCES NM
88005-2922
US

IV. Provider business mailing address

100 WYATT DR STE A
LAS CRUCES NM
88005-2922
US

V. Phone/Fax

Practice location:
  • Phone: 575-589-9000
  • Fax: 575-589-7000
Mailing address:
  • Phone: 575-589-9000
  • Fax: 575-589-7000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARGARITA HILDA PEREZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 575-589-9000