Healthcare Provider Details

I. General information

NPI: 1861721763
Provider Name (Legal Business Name): COORDINATED HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2009
Last Update Date: 12/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W BOUTZ RD BLDG 2
LAS CRUCES NM
88005-3259
US

IV. Provider business mailing address

205 W BOUTZ RD BLDG 2
LAS CRUCES NM
88005-3259
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-8885
  • Fax: 575-525-3137
Mailing address:
  • Phone: 575-523-8885
  • Fax: 575-525-3137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number673
License Number StateNM

VIII. Authorized Official

Name: MS. CYNTHIA CARLSON
Title or Position: CONTROLLER
Credential:
Phone: 57554142022