NPIMap

Organization Active NPI

Enchanted Hills Home Healthcare Agency, Inc.

  • Home Health Agency
  • Rio Rancho, NM
National Provider Identifier
1578672424
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
3202 Issued in NM
Legal business name
ENCHANTED HILLS HOME HEALTHCARE AGENCY, INC.
Practice address
7555 Enchanted Hills Blvd.
Suite 200
Rio Rancho, NM 87144-8525
Phone
(505) 867-0621
Fax
(505) 867-0623
NPI assigned
Aug 30, 2006
Last updated
Jun 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Authorized official

Name
Mrs. Melissa Kellene Johns, RN
Title
Owner
Phone
(505) 867-0621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 3202 NM Primary

Addresses

Primary practice location

7555 Enchanted Hills Blvd.
Suite 200
Rio Rancho, NM 87144-8525

Mailing address

7555 Enchanted Hills Blvd NE
Suite 200
Rio Rancho, NM 87144-8625
Phone (505) 867-0621

Other identifiers 2

IdentifierTypeStateIssuer
75208067MedicaidNM
94935505MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Enchanted Hills Home Healthcare Agency Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7555 Enchanted Hills Blvd NE
Ste 200
Rio Rancho, NM 87144
Phone (505) 867-0621

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1578672424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 ENCHANTED HILLS BLVD NE",
            "address_2": "SUITE 200",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871448625",
            "telephone_number": "505-867-0621",
            "fax_number": "505-867-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 ENCHANTED HILLS BLVD.",
            "address_2": "SUITE 200",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871448525",
            "telephone_number": "505-867-0621",
            "fax_number": "505-867-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCHANTED HILLS HOME HEALTHCARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "KELLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-867-0621",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "3202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75208067",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94935505",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.