Healthcare Provider Details

I. General information

NPI: 1780121459
Provider Name (Legal Business Name): COMPLETE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 E LOHMAN AVE
LAS CRUCES NM
88001-3172
US

IV. Provider business mailing address

1990 E LOHMAN AVE
LAS CRUCES NM
88001-3172
US

V. Phone/Fax

Practice location:
  • Phone: 915-276-3851
  • Fax:
Mailing address:
  • Phone: 915-276-3851
  • Fax:

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: YVONNE A BASIL
Title or Position: CERTIFIED NURSE PRACTITIONER
Credential: CNP
Phone: 915-276-3851