MEDICARE: ALL SEASONS HOME CARE, 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
1	376J00000X	Homemaker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346460201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL SEASONS HOME CARE, INC.

Provider Business Mailing Address
First Line	:	2509 VERMONT ST NE
Second Line	:	D 102
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2509 VERMONT ST NE
Second Line	:	D 102
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4688
Country	:	US
Telephone Number	:	505-883-7383
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. THOMAS EUGENE TOLLISON
Credential	:
Telephone Number	:	505-883-7383

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	08/22/2020

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Directions to “ALL SEASONS HOME CARE, INC. ” Practice Location

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