MEDICARE: INNOVATIVE HEALTH AT HOME INCORPORATED

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	251B00000X	Case Management Agency
2	251E00000X	Home Health Agency

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407999469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE HEALTH AT HOME INCORPORATED

Provider Business Mailing Address
First Line	:	7801 ACADEMY ROAD NE
Second Line	:	BUILDING 2, SUITE 104
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-3189
Country	:	US
Telephone Number	:	505-883-0665
Fax Number	:	505-883-3103

Provider Business Practice Location Address
First Line	:	7801 ACADEMY ROAD NE
Second Line	:	BUILDING 2, SUITE 104
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-3189
Country	:	US
Telephone Number	:	505-883-0665
Fax Number	:	505-883-3103

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. RICHARD E ZAMORA
Credential	:	LISW
Telephone Number	:	505-883-0665

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	09/11/2025

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Directions to “INNOVATIVE HEALTH AT HOME INCORPORATED ” Practice Location

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