Healthcare Provider Details

I. General information

NPI: 1720113541
Provider Name (Legal Business Name): PERSONAL LIVING SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/11/2024
Certification Date: 08/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 STATE HIGHWAY 47
LOS LUNAS NM
87031-7544
US

IV. Provider business mailing address

PO BOX 7207
ALBUQUERQUE NM
87194-7207
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-8813
  • Fax: 505-865-4866
Mailing address:
  • Phone: 505-865-8813
  • Fax: 505-865-4866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SUZETTE LINDEMUTH
Title or Position: DIRECTOR
Credential:
Phone: 505-865-8813