- Enrollment id
- O20070607000216
- Enrollment state
- NM
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1356531867
- Multiple npi flag
- N
- Ccn
- 327195
- Associate id
- 2466550983
- Organization name
- NM CUIDADO CASERO HOME HEALTH LLC
- Doing business as name
- NEW MEXICO CUIDADO CASERO HOME HEALTH
- Incorporation date
- 2006-10-30
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 820 ANTHONY DRIVE
- Address line 2
- SUITE A
- City
- ANTHONY
- State
- NM
- Zip code
- 880219346