Provider Demographics
NPI:1912273251
Name:ALMA HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:ALMA HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:IV
Authorized Official - Credentials:LVN,DSD, INSTRUCTOR
Authorized Official - Phone:505-907-5984
Mailing Address - Street 1:8216 PERIDOT AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-8334
Mailing Address - Country:US
Mailing Address - Phone:505-907-5984
Mailing Address - Fax:505-717-2472
Practice Address - Street 1:8216 PERIDOT AVE SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-8334
Practice Address - Country:US
Practice Address - Phone:505-907-5984
Practice Address - Fax:505-717-2472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care