Healthcare Provider Details

I. General information

NPI: 1427853530
Provider Name (Legal Business Name): HOME HEALTH PERSONAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W EVANS AVE
TUCUMCARI NM
88401-3670
US

IV. Provider business mailing address

PO BOX 97
TUCUMCARI NM
88401-0097
US

V. Phone/Fax

Practice location:
  • Phone: 575-242-6909
  • Fax:
Mailing address:
  • Phone: 719-421-0633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GORECKI
Title or Position: OPERATIONS MANAGER
Credential: AAS
Phone: 719-421-0633