Healthcare Provider Details

I. General information

NPI: 1487096491
Provider Name (Legal Business Name): LAS CRUCES HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3948 E LOHMAN AVE STE 3
LAS CRUCES NM
88011-8153
US

IV. Provider business mailing address

3948 E LOHMAN AVE STE 3
LAS CRUCES NM
88011-8153
US

V. Phone/Fax

Practice location:
  • Phone: 575-652-3867
  • Fax:
Mailing address:
  • Phone: 575-652-3867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3483
License Number StateNM

VIII. Authorized Official

Name: MS. LAURIE J HOLTSFORD
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-465-7466