Organization Active NPI

Las Cruces Comprehensive Rehabilitation Inc.

  • Home Health Agency
  • Las Cruces, NM
National Provider Identifier
1043553670
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IT-3435 Issued in NM
Legal business name
LAS CRUCES COMPREHENSIVE REHABILITATION INC.
Practice address
4151 Camino Coyote
P.O. 13759
Las Cruces, NM 88011-7096
Phone
(575) 522-0484
Fax
(575) 522-0483
NPI assigned
Apr 2, 2013
Organization subpart
Yes
Parent organization
LAS CRUCES COMPREHENSIVE REHABILITATION INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ava Borde
Title
Coo
Phone
(575) 522-0484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IT-3435 NM Primary

Addresses

Primary practice location

4151 Camino Coyote
P.O. 13759
Las Cruces, NM 88011-7096

Mailing address

4151 Camino Coyote
Las Cruces, NM 88011-7096
Phone (575) 522-0484

Other names 1

  • Las Cruces Home Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140131001799 NM Part A Provider - Home Health Agency 2062661127 Practice locations: Las Cruces, NM

Home health agency certification: CCN 327222

Legal name
LAS CRUCES COMPREHENSIVE REHABILITATION INC
Doing business as
LAS CRUCES HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 20, 2014
Last certification
Jul 22, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 29, 2011 in NM
Enrollment address
4151 Camino Coyote
Las Cruces, NM 88011-7096

Care Compare: Home health agency

Medicare Care Compare
Listed as
Las Cruces Home CareCCN 327222
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jun 20, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Physical therapy

National Provider Directory

National Provider Directory
Part of
Las Cruces Comprehensive Rehabilitation Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2540 S Telshor Blvd
Ste B
Las Cruces, NM 88011
Phone (575) 522-0484

4151 Camino Coyote
Las Cruces, NM 88011
Phone (575) 522-0484

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Arlie Borde Individual Corporate Director Aug 21, 2016
Las Cruces Comprehensive Rehabilitation Inc Organization, Las Cruces, NM For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2011 100%
Ava Borde Individual Corporate OfficerCoo May 20, 2016
W-2 Managing EmployeeCoo May 20, 2016
Operational/Managerial ControlCoo May 20, 2016
Brandon Barker Individual Corporate Officer Aug 21, 2016
Corporate Director Aug 21, 2016
Larry Barker Individual 5% Or Greater Indirect Ownership Interest May 20, 2016 100%
Corporate OfficerBoard Member/Officer May 20, 2016
Corporate DirectorBoard Member/Officer May 20, 2016
Operational/Managerial ControlBoard Member/Officer May 20, 2016
Las Cruces Rehabilitation Management LLC Organization, Las Cruces, NM LLC 5% Or Greater Direct Ownership Interest May 20, 2016 100%
Operational/Managerial Control May 20, 2016
Harold Morrow Individual Corporate Officer Aug 21, 2016
Andie Gray Individual Corporate Director Aug 21, 2016

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1043553670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 CAMINO COYOTE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880117096",
            "telephone_number": "575-522-0484",
            "fax_number": "575-522-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 CAMINO COYOTE",
            "address_2": "P.O. 13759",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880117096",
            "telephone_number": "575-522-0484",
            "fax_number": "575-522-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS CRUCES COMPREHENSIVE REHABILITATION INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAS CRUCES COMPREHENSIVE REHABILITATION INC.",
        "enumeration_date": "2013-04-02",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "BORDE",
        "authorized_official_first_name": "AVA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "575-522-0484"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "IT-3435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Cruces Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Las Cruces Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.