Provider Demographics
NPI:1275260721
Name:OUR PEOPLES HOMECARE LLC
Entity Type:Organization
Organization Name:OUR PEOPLES HOMECARE LLC
Other - Org Name:OPHC LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JAROLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:505-258-4368
Mailing Address - Street 1:216 E APACHE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6904
Mailing Address - Country:US
Mailing Address - Phone:505-258-4368
Mailing Address - Fax:505-258-4356
Practice Address - Street 1:216 E APACHE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6904
Practice Address - Country:US
Practice Address - Phone:505-258-4368
Practice Address - Fax:505-258-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM6868231OtherSECRETARY OF STATE
NM6868231OtherCERTIFICATE OF GOOD STANDING AND COMPLIANCE
NM69077762Medicaid
NM22-00013305OtherCITY OF FARMINGTON