Provider Demographics
NPI:1639514342
Name:TAKECARE LLC
Entity Type:Organization
Organization Name:TAKECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNHAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-944-5695
Mailing Address - Street 1:12231 ACADEMY RD NE
Mailing Address - Street 2:#301-231
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12231 ACADEMY RD NE
Practice Address - Street 2:#301-231
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-7236
Practice Address - Country:US
Practice Address - Phone:505-944-5695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health