Provider Demographics
NPI:1578933396
Name:ARMADA SKILLED HOMECARE OF NEW MEXICO LLC
Entity Type:Organization
Organization Name:ARMADA SKILLED HOMECARE OF NEW MEXICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-3400
Mailing Address - Street 1:2300 WARRENVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1717
Mailing Address - Country:US
Mailing Address - Phone:630-296-3400
Mailing Address - Fax:
Practice Address - Street 1:5501 WILSHIRE AVE NE STE Y
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2569
Practice Address - Country:US
Practice Address - Phone:505-847-2388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM86423266Medicaid
327225Medicare Oscar/Certification