MEDICARE: VETERAN HOME CARE LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1508738717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VETERAN HOME CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 66539
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87193-6539
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12020 N 35TH AVE STE 101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-3213
Country	:	US
Telephone Number	:	505-266-6683
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEVE TRACY
Credential	:
Telephone Number	:	505-266-6683

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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