Provider Demographics
NPI:1346460201
Name:ALL SEASONS HOME CARE, INC.
Entity Type:Organization
Organization Name:ALL SEASONS HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:TOLLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-883-7383
Mailing Address - Street 1:2509 VERMONT ST NE
Mailing Address - Street 2:D 102
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4688
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2509 VERMONT ST NE
Practice Address - Street 2:D 102
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4688
Practice Address - Country:US
Practice Address - Phone:505-883-7383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD1363Medicaid