# MONTE CRISTO HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003658774
- **Authorized official:** DANIEL BUSTILLOS DNP (OWNER)
- **Authorized official phone:** (915) 244-4966

## Contact information

- **Practice address:** 5805 MCNUTT RD STE D, SANTA TERESA, NM 88008-8001
- **Practice address phone:** (575) 332-4007
- **Practice address fax:** (575) 332-4453
- **Mailing address:** 5805 MCNUTT RD STE D, SANTA TERESA, NM 88008-8001
- **Mailing address phone:** (575) 332-4007
- **Mailing address fax:** (575) 332-4453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/12/2024
- **Last updated:** 09/06/2024