Organization Active NPI

Advanticare Home Health Services,LLC

  • In Home Supportive Care Agency
  • Albuquerque, NM
National Provider Identifier
1255648564
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ADVANTICARE HOME HEALTH SERVICES,LLC
Practice address
3620 Wyoming Blvd NE
Suite 130
Albuquerque, NM 87111-3297
Phone
(505) 292-5222
Fax
(505) 292-5333
NPI assigned
Sep 8, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Lolita Begay-Yazzie
Title
Administrator
Phone
(505) 292-5222

National Provider Directory

National Provider Directory

Locations

3620 Wyoming Blvd NE
Ste 130
Albuquerque, NM 87111
Phone (505) 292-5222

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

3620 Wyoming Blvd NE
Suite 130
Albuquerque, NM 87111-3297

Mailing address

PO Box 11353
Albuquerque, NM 87192-0353
Phone (505) 292-5222

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
60238569MedicaidNM

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 8, 2010.

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1255648564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11353",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871920353",
            "telephone_number": "505-292-5222",
            "fax_number": "505-292-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 WYOMING BLVD NE",
            "address_2": "SUITE 130",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113297",
            "telephone_number": "505-292-5222",
            "fax_number": "505-292-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTICARE HOME HEALTH SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "BEGAY-YAZZIE",
        "authorized_official_first_name": "LOLITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "505-292-5222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60238569",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.