Provider Demographics
NPI:1578968285
Name:REYES HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:REYES HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:NICKOL
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-206-4841
Mailing Address - Street 1:1504 SPENCE AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-5016
Mailing Address - Country:US
Mailing Address - Phone:505-206-4841
Mailing Address - Fax:
Practice Address - Street 1:1504 SPENCE AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-5016
Practice Address - Country:US
Practice Address - Phone:505-206-4841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-73898251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health