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General NPI Number Information
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NPI Number | 1831321116
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Entity Type | Organization
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Legal Business Name | ABANZA PERSONAL CARE SERVICES LLC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 1717 LOUISANA BLVD NE SUITE 102
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7014
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Country | US
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Telephone | 505-554-1012
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Fax | 505-554-3967
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Provider Business Mailing Address
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Address Line | 1717 LOUISIANA BLVD NE STE 102
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7014
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Country | US
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Telephone | 505-554-1012
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Fax | 505-554-3967
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CLARA ZULMA VALDEZ
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Credential |
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Telephone | 505-554-1012
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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 | 03-169549-00-3
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License Number State | NM
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