# ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Roosevelt General Hospital Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235324815
- **Authorized official:** GARY PARTIN (DIRECTOR)
- **Authorized official phone:** (505) 226-4663

## Contact information

- **Practice address:** 1412 SOUTH AVENUE O, SUITE B, PORTALES, NM 88130-7091
- **Practice address phone:** (505) 226-4663
- **Practice address fax:** (505) 226-4664
- **Mailing address:** PO BOX 868, PORTALES, NM 88130-0868
- **Mailing address phone:** (505) 226-4663
- **Mailing address fax:** (505) 226-4664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 3178 | NM | Yes |

## Other

- **Enumeration date:** 09/07/2007
- **Last updated:** 12/20/2007