Provider Demographics
NPI:1720801434
Name:TOTAL HEALTHCARE PILLARS LLC
Entity type:Organization
Organization Name:TOTAL HEALTHCARE PILLARS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGAEZI
Authorized Official - Middle Name:ULOMA
Authorized Official - Last Name:UKWUOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-662-8294
Mailing Address - Street 1:601 MENAUL BLVD NE UNIT 3303
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1549
Mailing Address - Country:US
Mailing Address - Phone:832-662-8294
Mailing Address - Fax:
Practice Address - Street 1:601 MENAUL BLVD NE UNIT 3303
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1549
Practice Address - Country:US
Practice Address - Phone:832-662-8294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care