Thi of New Mexico at En Su Casa LLC

Organization Active NPI Personal Care Attendant · Lordsburg, NM

NPI 1194932707 · NPPES record last updated Mar 11, 2008

Key facts

NPI
1194932707
Entity type
Organization (NPI type 2)
Primary specialty
Personal Care Attendant 3747P1801X
Legal business name
THI OF NEW MEXICO AT EN SU CASA LLC
Practice address
524 De Moss St
Suite 12
Lordsburg, NM 88045-2626
Phone
(505) 542-3130
NPI assigned
May 16, 2007
Organization subpart
No

Authorized official

Name
Josie Pebsworth
Title
President
Phone
(505) 522-7000

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
En Su Casa Personal Care (4 organizations share this tax ID)

Locations

524 De Moss St
Ste 12
Lordsburg, NM 88045
Phone (505) 542-3130

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant
Group: 193400000X SINGLE SPECIALTY GROUP
3747P1801X Yes

Addresses

Primary practice location

524 De Moss St
Suite 12
Lordsburg, NM 88045-2626

Mailing address

930 Ridgebrook Rd
Sparks, MD 21152-9390

Other identifiers

IdentifierTypeStateIssuer
66836361MedicaidNM

Other names

  • En Su Casa Personal Care Doing business as

Other providers in Lordsburg, NM

All providers in Lordsburg, NM · Personal Care Attendant in New Mexico

Sources for this page

Verify at the official NPI Registry.