Organization
PHC-LAS CRUCES INC
Active
Other names
Memorial Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE DILLON (ASSISTANT SECRETARY)
(502) 596-7220
Entity
Organization
Contact information
Practice address
1705 E UNIVERSITY AVE, SUITE A, LAS CRUCES, NM 88001-5780
(575) 556-6500
(575) 522-4168
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3172
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201060532
PRESBYTERIAN HEALTH
NM
05
—
98921576
—
NM
01
—
NM01HH76
BDBS
NM
01
—
PROVA21336
MOLINA HEALTHCARE
NM
Enumeration date
11/07/2006
Last updated
04/26/2022
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