Healthcare Provider Details

I. General information

NPI: 1659203834
Provider Name (Legal Business Name): FIRST LOS ALAMOS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CENTRAL AVE APT 703
LOS ALAMOS NM
87544-3312
US

IV. Provider business mailing address

510 CENTRAL AVE APT 703
LOS ALAMOS NM
87544-3312
US

V. Phone/Fax

Practice location:
  • Phone: 832-207-4657
  • Fax:
Mailing address:
  • Phone: 832-207-4657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: NNEKA G ANYICHIE
Title or Position: HOMECARE
Credential:
Phone: 832-207-4657