Healthcare Provider Details

I. General information

NPI: 1114045820
Provider Name (Legal Business Name): OPEN HANDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2976 RODEO PARK DRIVE EAST
SANTA FE NM
87505-6351
US

IV. Provider business mailing address

2976 RODEO PARK DRIVE EAST
SANTA FE NM
87505-6351
US

V. Phone/Fax

Practice location:
  • Phone: 505-428-2320
  • Fax: 505-428-2361
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number5458
License Number StateNM

VIII. Authorized Official

Name: LISA BRONOWICZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-428-2363