Healthcare Provider Details

I. General information

NPI: 1144163080
Provider Name (Legal Business Name): TOBOSA DEVELOPMENTAL SERVICES- HOME VISITING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 EAST SUMMIT
ROSWELL NM
88203
US

IV. Provider business mailing address

2110 S. MAIN ST
ROSWELL NM
88203
US

V. Phone/Fax

Practice location:
  • Phone: 575-624-1025
  • Fax:
Mailing address:
  • Phone: 575-624-1025
  • 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: CRYSTAL L. ARMENDARIZ
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 575-624-1025