Provider Demographics
NPI:1710284583
Name:SANDIA HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SANDIA HOME HEALTH CARE, LLC
Other - Org Name:SANDIA HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:
Authorized Official - Credentials:MAHR
Authorized Official - Phone:505-292-5203
Mailing Address - Street 1:10410 SIERRA BONITA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111
Mailing Address - Country:US
Mailing Address - Phone:505-292-5203
Mailing Address - Fax:866-815-3410
Practice Address - Street 1:10410 SIERRA BONITA AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111
Practice Address - Country:US
Practice Address - Phone:505-292-5203
Practice Address - Fax:866-815-3410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251V00000XAgenciesVoluntary or Charitable