Healthcare Provider Details

I. General information

NPI: 1710397641
Provider Name (Legal Business Name): RAYOS DE LUZ HOME HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 MED PARK DR
LAS CRUCES NM
88005-3238
US

IV. Provider business mailing address

1161 MED PARK DR
LAS CRUCES NM
88005-3238
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-0057
  • Fax: 575-652-3682
Mailing address:
  • Phone: 575-523-0057
  • Fax: 575-652-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MARTIN R ROBINSON
Title or Position: PRESIDENT
Credential:
Phone: 575-523-0057