Healthcare Provider Details

I. General information

NPI: 1093136574
Provider Name (Legal Business Name): ARMADA HOME HEALTHCARE OF SOCORRO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2013
Last Update Date: 01/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 COTTONWOOD DR NW
LOS RANCHOS NM
87107-6751
US

IV. Provider business mailing address

1039 COTTONWOOD DR NW
LOS RANCHOS NM
87107-6751
US

V. Phone/Fax

Practice location:
  • Phone: 505-264-4325
  • Fax:
Mailing address:
  • Phone: 505-264-4325
  • Fax:

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: CHRISTOPHER E TAPIA
Title or Position: MANAGER
Credential:
Phone: 505-264-4325