Provider Demographics
NPI:1386045268
Name:HOME MODIFICATION SOLUTIONS, LLC
Entity type:Organization
Organization Name:HOME MODIFICATION SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWDICAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-341-9060
Mailing Address - Street 1:PO BOX 92978
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-2978
Mailing Address - Country:US
Mailing Address - Phone:505-341-9060
Mailing Address - Fax:
Practice Address - Street 1:8516 CALLE ALAMEDA NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1560
Practice Address - Country:US
Practice Address - Phone:505-341-9060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMBRC-2014-332244171WH0202X
253Z00000X
NMFA0114064332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM01622293Medicaid