# RUSTIC HEALTH LLC

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

## Provider details

- **NPI number:** 1215649629
- **Authorized official:** DAVID J DONAVAN LPN (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (575) 479-7773

## Contact information

- **Practice address:** 405 N DATE ST STE 4, T OR C, NM 87901-2378
- **Practice address phone:** (575) 297-4993
- **Practice address fax:** (575) 205-0274
- **Mailing address:** 1301 CUBA AVE, ALAMOGORDO, NM 88310-5727
- **Mailing address phone:** (575) 479-7773
- **Mailing address fax:** (575) 205-0274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | — |
| 251J00000X | Nursing Care Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | — | — |
| 385H00000X | Respite Care | — | — | — |

## Other

- **Enumeration date:** 12/16/2022
- **Last updated:** 03/31/2026