Healthcare Provider Details

I. General information

NPI: 1154815488
Provider Name (Legal Business Name): TRIPPLE CROSS HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 N VALLEY DR
LAS CRUCES NM
88007-6844
US

IV. Provider business mailing address

4020 N VALLEY DR
LAS CRUCES NM
88007-6844
US

V. Phone/Fax

Practice location:
  • Phone: 575-571-2724
  • Fax:
Mailing address:
  • Phone: 575-571-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE M MERAZ
Title or Position: OWNER
Credential:
Phone: 575-571-2724