Healthcare Provider Details

I. General information

NPI: 1932855673
Provider Name (Legal Business Name): PROMISES KEPT HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 6TH ST N
SOCORRO NM
87801-4225
US

IV. Provider business mailing address

402 6TH ST N
SOCORRO NM
87801-4225
US

V. Phone/Fax

Practice location:
  • Phone: 575-838-2619
  • Fax: 575-838-2228
Mailing address:
  • Phone: 575-838-2619
  • Fax: 575-838-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. NOAH D. JARAMILLO
Title or Position: MANAGING MEMBER -DIRECTOR
Credential:
Phone: 575-838-2619