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NPI Code Detail

MEDICARE: LAS CRUCES COMPREHENSIVE REHABILITATION INC.

MEDICARE: LAS CRUCES COMPREHENSIVE REHABILITATION INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyIT-3435NM

General Provider Information

NPI Number : 1043553670
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAS CRUCES COMPREHENSIVE REHABILITATION INC.
Provider Business Mailing Address
First Line : 4151 CAMINO COYOTE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-7096
Country : US
Telephone Number : 575-522-0484
Fax Number : 575-522-0483
Provider Business Practice Location Address
First Line : 4151 CAMINO COYOTE
Second Line : P.O. 13759
City : LAS CRUCES
State : NM
Zip : 88011-7096
Country : US
Telephone Number : 575-522-0484
Fax Number : 575-522-0483
Authorized Official
Title or Position : COO
Name : AVA BORDE
Credential :
Telephone Number : 575-522-0484
Provider Enumeration Date : 04/02/2013
Last Update Date : 07/12/2021

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Directions to “LAS CRUCES COMPREHENSIVE REHABILITATION INC. ” Practice Location

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