1609039833 NPI number — AMBERCARE HOME HEALTH CARE CORPORATION

Table of content: (NPI 1609039833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609039833 NPI number — AMBERCARE HOME HEALTH CARE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMBERCARE HOME HEALTH CARE CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609039833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6303 COWBOYS WAY STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-0329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-535-8200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3870 FOOTHILLS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS CRUCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88011-4631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-652-5766
Provider Business Practice Location Address Fax Number:
575-556-0460
Provider Enumeration Date:
07/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
DARBY
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP, CHIEF STRATEGY OFFICER
Authorized Official Telephone Number:
630-296-3591

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  6537B1 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 6537 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: N2836 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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