# ISLETA ELDERLY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Isleta PCO Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770708174
- **Authorized official:** MRS. KATHY BLACK M.S. (DIRECTOR)
- **Authorized official phone:** (505) 869-6661

## Contact information

- **Practice address:** TRIBAL RD. 40 BLDG. 70, ISLETA, NM 87022
- **Practice address phone:** (505) 869-6661
- **Practice address fax:** (505) 869-2736
- **Mailing address:** PO BOX 1270, ISLETA, NM 87022-1270
- **Mailing address phone:** (505) 869-6661
- **Mailing address fax:** (505) 869-2736

## Taxonomy

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

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 08/22/2020