Healthcare Provider Details

I. General information

NPI: 1598612798
Provider Name (Legal Business Name): SANDIA VISTA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7324 NAGOYA RD NE
RIO RANCHO NM
87144-3530
US

IV. Provider business mailing address

7324 NAGOYA RD NE
RIO RANCHO NM
87144-3530
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-3037
  • Fax:
Mailing address:
  • Phone: 505-440-3037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA E CHAVEZ
Title or Position: OWNER
Credential:
Phone: 505-440-3037