Healthcare Provider Details
I. General information
NPI: 1518010222
Provider Name (Legal Business Name): ASSURANCE HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 E 18TH ST
ROSWELL NM
88201-7532
US
IV. Provider business mailing address
1000 E 18TH ST
ROSWELL NM
88201-7532
US
V. Phone/Fax
- Phone: 575-624-1780
- Fax: 575-624-2033
- Phone: 575-624-1780
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 322D00000X |
| Taxonomy | Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | 4079 |
| License Number State | NM |
VIII. Authorized Official
Name:
ALYCIA
WRIGHT
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 575-624-1780