Provider Demographics
NPI:1972664688
Name:HOME KARE INC., OF DONA ANA
Entity Type:Organization
Organization Name:HOME KARE INC., OF DONA ANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:BENAVIDEZ
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:505-521-2663
Mailing Address - Street 1:2303 DIVOT AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-8417
Mailing Address - Country:US
Mailing Address - Phone:575-521-2663
Mailing Address - Fax:575-521-3046
Practice Address - Street 1:2303 DIVOT AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-8417
Practice Address - Country:US
Practice Address - Phone:575-521-2663
Practice Address - Fax:575-521-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6404251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMA1606Medicaid
NMN2514Medicaid
NMN2514Medicaid