Provider Demographics
NPI:1558334052
Name:DEMING HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:DEMING HOME CARE SERVICES LLC
Other - Org Name:MIMBRES VALLEY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS OFFICE SUPPORT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:113 N. PEARL STREET
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-3755
Mailing Address - Country:US
Mailing Address - Phone:575-544-4663
Mailing Address - Fax:575-544-4665
Practice Address - Street 1:113 N. PEARL STREET
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-3755
Practice Address - Country:US
Practice Address - Phone:575-544-4663
Practice Address - Fax:575-544-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6544251G00000X
NM3300251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMK3315Medicaid
NMK3315Medicaid