Provider Demographics
NPI:1710686522
Name:LOBO HOME CARE OF ALBUQUERQUE LLC
Entity Type:Organization
Organization Name:LOBO HOME CARE OF ALBUQUERQUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO/ADMIN/DON
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAURIGUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-363-9002
Mailing Address - Street 1:3738 ISLETA BLVD SW STE C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-5920
Mailing Address - Country:US
Mailing Address - Phone:505-363-9002
Mailing Address - Fax:
Practice Address - Street 1:3738 ISLETA BLVD SW STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-5920
Practice Address - Country:US
Practice Address - Phone:505-363-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health