=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962330845
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUSTED ROOTS CAREGIVING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2026
-----------------------------------------------------
Last Update Date | 05/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2405 FRED DAUGHERTY AVE
-----------------------------------------------------
City | CLOVIS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88101-1610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-573-7539
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2405 FRED DAUGHERTY AVE
-----------------------------------------------------
City | CLOVIS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88101-1610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-573-7539
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. KRISTINE RUTH SCRUGGS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-573-7539
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------