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Organization

GONZALES FAMILY, INC

Active
Other names
Alternative Home Health Care
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MAXINE E GONZALES (ADMINISTRATOR)
(505) 425-1538
Entity
Organization

Contact information

Practice address
1118 NATIONAL AVE, LAS VEGAS, NM 87701-4025
(505) 425-1538
(505) 425-7682
Mailing address
1118 NATIONAL AVE, LAS VEGAS, NM 87701-4025
(505) 425-1538
(505) 425-7682

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
6211
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32-7099
MEDICARE LEGACY NUMBER
NM
Enumeration date
08/18/2006
Last updated
11/09/2007
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