Enchantment Legacy, Inc.
Organization Active NPI In Home Supportive Care Agency · Estancia, NM
NPI 1306232038 · NPPES record last updated Apr 9, 2015
Key facts
- NPI
- 1306232038
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- 172V00000X (NM)
- Legal business name
- ENCHANTMENT LEGACY, INC.
- Practice address
- 514 Williams Ave
Estancia, NM 87016-0697 - Phone
- (505) 384-3032
- Fax
- (505) 384-3033
- NPI assigned
- Apr 9, 2015
- Organization subpart
- No
Authorized official
- Name
- Mrs. Theresa L. Muth
- Title
- Executive Director
- Phone
- (505) 384-3032
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Enchantment Legacy Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 172V00000X | NM | Yes |
Addresses
Primary practice location
514 Williams Ave
Estancia, NM 87016-0697
Mailing address
PO Box 697
Estancia, NM 87016-0697
Phone (505) 384-3032
Other providers in Estancia, NM
- Charles F Brady
- Melonie Suzzane Chavez
- Corrections Corp. of America
- Alyson Deakyne
- Enchantment Legacy Inc.
- Ellen Espinosa
- Oliver Matthew Gallegos
- Deminica Denee Garcia
- Emily Gottschalk
- Pamela Jo Hartman
All providers in Estancia, NM · In Home Supportive Care Agency in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.