Provider Demographics
NPI:1124650817
Name:UNITED ONE HOME CARE LLC
Entity type:Organization
Organization Name:UNITED ONE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MBAEZUE
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:915-443-2836
Mailing Address - Street 1:512 EL SHADDAI ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-2571
Mailing Address - Country:US
Mailing Address - Phone:505-295-2044
Mailing Address - Fax:844-255-7040
Practice Address - Street 1:3321B CANDELARIA RD NE OFC 320
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1908
Practice Address - Country:US
Practice Address - Phone:915-443-2836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health