Provider Demographics
NPI:1831859099
Name:HOMECARE HUB OF NEW MEXICO, LLC
Entity type:Organization
Organization Name:HOMECARE HUB OF NEW MEXICO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-581-7878
Mailing Address - Street 1:8400 E PRENTICE AVE PH 1500
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2927
Mailing Address - Country:US
Mailing Address - Phone:616-581-7878
Mailing Address - Fax:
Practice Address - Street 1:5901 INDIAN SCHOOL RD NE STE 103
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5200
Practice Address - Country:US
Practice Address - Phone:515-985-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care