Organization
BEHAVIORAL HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE A GONZALEZ B.S., M.B.A. (PRESIDENT)
(505) 892-1830
Entity
Organization
Contact information
Practice address
1453 RIO RANCHO DR SE STE C, RIO RANCHO, NM 87124-1837
(505) 892-1830
(505) 896-1539
Mailing address
1453 RIO RANCHO DR SE STE C, RIO RANCHO, NM 87124-1837
(505) 892-1830
(505) 896-1539
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0600098189
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70884579
—
NM
05
—
K2335
—
NM
Enumeration date
01/23/2007
Last updated
08/22/2020
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