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General NPI Number Information
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NPI Number | 1043648165
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Entity Type | Organization
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Legal Business Name | OPEN DOORS HOME HEALTH CARE
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 713 RAILROAD AVE.
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City | LAS VEGAS
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State | NM
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Zip | 87701
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Country | US
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Telephone | 505-425-2687
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Fax | 505-454-7198
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Provider Business Mailing Address
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Address Line | 713 RAILROAD AVE.
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City | LAS VEGAS
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State | NM
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Zip | 87701
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Country | US
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Telephone | 505-425-2687
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Fax | 505-454-7198
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALEJANDRO J. RIVERA
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Credential | LAD, MSW
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Telephone | 505-617-5846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 003267
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License Number State | NM
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