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General NPI Number Information
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NPI Number | 1235289968
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Entity Type | Organization
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Legal Business Name | LOS ALAMOS VISITING NURSE SERVICE, INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 109 CENTRAL PARK SQ
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City | LOS ALAMOS
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State | NM
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Zip | 87544-4020
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Country | US
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Telephone | 505-662-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 109 CENTRAL PARK SQ
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City | LOS ALAMOS
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State | NM
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Zip | 87544-4020
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Country | US
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Telephone | 505-662-2525
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | WENDI WOLFE
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Credential | RN
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Telephone | 505-662-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 6428
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | NM
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