Provider Demographics
NPI:1821070871
Name:ACCESS HOME HEALTH, LLC
Entity Type:Organization
Organization Name:ACCESS HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-434-6222
Mailing Address - Street 1:1211 8TH ST STE A
Mailing Address - Street 2:THUNDERBIRD BLDG
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-5834
Mailing Address - Country:US
Mailing Address - Phone:505-434-6222
Mailing Address - Fax:505-443-9090
Practice Address - Street 1:1600 INDIAN WELLS RD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4655
Practice Address - Country:US
Practice Address - Phone:505-434-6222
Practice Address - Fax:505-443-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3191251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM327194Medicare ID - Type UnspecifiedPROVIDER NUMBER