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General NPI Number Information
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NPI Number | 1578968285
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Entity Type | Organization
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Legal Business Name | REYES HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 1504 SPENCE AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-5016
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Country | US
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Telephone | 505-206-4841
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 SPENCE AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-5016
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Country | US
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Telephone | 505-206-4841
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Fax |
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Authorized Official
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Title or Position | RN/ADMINISTRATOR/OWNER
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Name | MS. DARLENE NICKOL GONZALES
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Credential | RN
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Telephone | 505-206-4841
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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 | RN-73898
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License Number State | NM
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