LIFE SUPPORT HOME HEALTH INC (NPI# 1154507739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154507739 |
| Entity Type | Organization |
| Organization Name | LIFE SUPPORT HOME HEALTH INC |
| Practice Address |
12901 Sand Cherry Pl Ne Albuquerque NM 87111 |
| Practice Telephone | 5058561321 |
| Practice Fax Number | 5057971328 |
| Mailing Telephone | 5058561321 |
| Mailing Fax Number | 5057971328 |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |
| Authorized Official Name | MISS CANDICE M SPARKS (PRESIDENT) |
| Authorized Official Telephone | 5058211107 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 6775A1 | NM | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | MEDICAID WAIVER | D4145 | 01 |
| Street Address |
12901 SAND CHERRY PL NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417438110 | Dehlen LLC | Counselor | 11000 Spain Rd Ne, Building E, Albuquerque, NM 87111 | 2018-08-22 |
| 1003313008 | Jessika Junick | Nurse Practitioner | 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 | 2018-04-07 |
| 1881113454 | Hayley Aragon-bell | Day Training/Habilitation Specialist | 3732 Mount Rainier Dr. Ne, Albuquerque, NM 87111 | 2017-09-14 |
| 1750803326 | Sarah Mckenzie Ochoa | Day Training/Habilitation Specialist | 3916 Garcia St Ne, Albuquerque, NM 87111 | 2017-07-14 |
| 1285179549 | Family Dental Health Care | Dentist | 4550 Eubank Blvd, Suite 203, Albuquerque, NM 87111 | 2016-12-22 |
| 1871036202 | Shobha Jagannath | Nurse Practitioner | 10700 Academy Rd Ne Apt 216, Albuquerque, NM 87111 | 2016-12-03 |
| 1508319310 | Mariana Boitano | Licensed Practical Nurse | 5400 Gibson Blvd., Albuquerque, NM 87111 | 2016-07-28 |
| 1184011082 | Adam Halpern | Specialist/Technologist | 4204 Parsifal St, Albuquerque, NM 87111 | 2015-04-20 |
| 1083015770 | Cvs Pharmacy | Public Health or Welfare | 5516 Camino Arbustos Ne, Albuquerque, NM 87111 | 2014-09-12 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in zip 87111 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386977 | Gina D Padilla | Home Health | 1307 San Pedro Dr Ne, Albuquerque, NM 87110-6727 | 2020-11-04 |
| 1598365066 | Ricelands Home Health Care and Hospice LLC | Home Health | 9215 Layton Ave Ne, Albuquerque, NM 87111-1335 | 2020-10-26 |
| 1073135216 | At Home Not Alone Care, LLC | Home Health | 3410 Anderson Ave Se Rear, Albuquerque, NM 87106-2408 | 2020-05-11 |
| 1396370383 | Md Health Care LLC | Home Health | 8019 Edith Blvd Ne Ste 206, Albuquerque, NM 87113-1433 | 2020-03-10 |
| 1124650817 | United One Home Care LLC | Home Health | 3321b Candelaria Rd Ne Ofc 320, Albuquerque, NM 87107-1908 | 2020-02-10 |
| 1316595184 | Simplicity Home Health Care | Home Health | 7920 Mountain Rd Ne Ste B, Albuquerque, NM 87110-7800 | 2019-08-26 |
| 1952960817 | Mary T Martinez | Home Health | 585 Osuna Rd Ne Ste F, Albuquerque, NM 87113-1084 | 2019-06-12 |
| 1689230658 | Norma Araceli Ortega | Home Health | 9319 Starboard Rd Nw, Albuquerque, NM 87121-1968 | 2019-05-15 |
| 1134618432 | Alexis Duran | Home Health | 11005 Desert Dreamer St Nw, Albuquerque, NM 87114-6509 | 2018-05-02 |
| 1821599226 | La Vita Bella Home Health LLC | Home Health | 5901 Indian School Rd Ne Ste 102, Albuquerque, NM 87110-5200 | 2018-02-22 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87111 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.