Healthcare Provider Details

I. General information

NPI: 1295893477
Provider Name (Legal Business Name): ADAPTIVE PERSONAL CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

472 COURTHOUSE RD SE
LOS LUNAS NM
87031-9270
US

IV. Provider business mailing address

472 COURTHOUSE RD SE
LOS LUNAS NM
87031-9270
US

V. Phone/Fax

Practice location:
  • Phone: 505-610-2899
  • Fax: 505-865-6605
Mailing address:
  • Phone: 505-610-2899
  • Fax: 505-865-6605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2485
License Number StateNM

VIII. Authorized Official

Name: NOEMI ROMERO
Title or Position: OWNER
Credential:
Phone: 505-610-2899