Organization
SAN VICENTE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MISTY D GONZALES RN (ADMINISTRATOR)
(505) 538-0912
Entity
Organization
Contact information
Practice address
200 N ARIZONA ST, SILVER CITY, NM 88061-4963
(505) 538-0912
(505) 538-0917
Mailing address
PO BOX 2307, SILVER CITY, NM 88062-2307
(505) 538-0912
(505) 538-0917
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
6549
NM
Other
Enumeration date
09/13/2006
Last updated
08/22/2020
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