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General NPI Number Information
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NPI Number | 1366110710
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Entity Type | Organization
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Legal Business Name | OSALTA LLC
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 6000 UPTOWN BLVD NE STE 330
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4332
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Country | US
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Telephone | 505-717-1324
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Fax | 505-944-1643
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Provider Business Mailing Address
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Address Line | 6000 UPTOWN BLVD NE STE 330
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4332
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Country | US
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Telephone | 505-717-1324
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Fax | 505-944-1643
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALLAIN TABAQUERO
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Credential |
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Telephone | 505-717-1324
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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 |
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License Number State |
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