Organization
ELITE HOME HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON FORREST RN (ADMINISTRATOR/OWNER)
(575) 393-9281
Entity
Organization
Contact information
Practice address
1508 N DAL PASO ST, HOBBS, NM 88240-4042
(575) 393-9281
(575) 393-9332
Mailing address
PO BOX 2368, HOBBS, NM 88241-2368
(575) 393-9281
(575) 393-9332
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3226
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32D1050113
CLIA CERTIFICATE OF WAIVE
NM
05
—
66376211
—
NM
Enumeration date
07/08/2006
Last updated
09/25/2009
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