Healthcare Provider Details

I. General information

NPI: 1215953617
Provider Name (Legal Business Name): MATRIX HOME CARE SERVICES OF NEW MEXICO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S MAIN ST STE A
LAS CRUCES NM
88005-2952
US

IV. Provider business mailing address

1100 S MAIN ST STE A
LAS CRUCES NM
88005-2952
US

V. Phone/Fax

Practice location:
  • Phone: 575-525-8755
  • Fax: 575-525-8795
Mailing address:
  • Phone: 575-525-8755
  • Fax: 575-525-8795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KATE CONNOLLY
Title or Position: CEO/ ADMINISTRATOR
Credential: MSN, RN, CNL
Phone: 214-817-9799