Organization
INNOVATIVE HEALTH AT HOME INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD E ZAMORA LISW (EXECUTIVE DIRECTOR)
(505) 883-0665
Entity
Organization
Contact information
Practice address
7801 ACADEMY ROAD NE, BUILDING 2, SUITE 104, ALBUQUERQUE, NM 87109-3189
(505) 883-0665
(505) 883-3103
Mailing address
7801 ACADEMY ROAD NE, BUILDING 2, SUITE 104, ALBUQUERQUE, NM 87109-3189
(505) 883-0665
(505) 883-3103
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00072335
—
NM
05
—
000D0553
—
NM
Enumeration date
02/15/2007
Last updated
09/11/2025
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