Provider Demographics
NPI:1902849136
Name:ALAMOGORDO HOME HEALTH CARE AND HOSPICE, INC
Entity Type:Organization
Organization Name:ALAMOGORDO HOME HEALTH CARE AND HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAT
Authorized Official - Middle Name:W
Authorized Official - Last Name:RAUB
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:575-437-3500
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88311-0029
Mailing Address - Country:US
Mailing Address - Phone:575-437-3500
Mailing Address - Fax:575-437-2399
Practice Address - Street 1:1859 INDIAN WELLS ROAD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310
Practice Address - Country:US
Practice Address - Phone:575-437-3500
Practice Address - Fax:575-437-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6063251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN2993Medicaid
NMN2993Medicaid