JANYCE WALLACE (NPI# 1255843330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255843330 |
| Entity Type | Individual |
| Full Name | JANYCE WALLACE |
| Practice Address |
7700 Ranchwood Dr Nw Albuquerque NM 87120-4020 |
| Mailing Address |
Po Box 68057 Albuquerque NM 87193-8057 |
| Practice Telephone | 5058363474 |
| Mailing Telephone | 5058363474 |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | NM | Residential Treatment Facilities |
| Street Address |
7700 RANCHWOOD DR NW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87120-4020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971919 | Erica Denise Ortiz | Social Worker | 6212 Casa Blanca Dr Nw, Albuquerque, NM 87120 | 2020-10-27 |
| 1770133589 | Laura Lee Smith | Technician | 5112 Vista De Luz Nw, Albuquerque, NM 87120 | 2019-09-13 |
| 1285282715 | Aiden Charles Martinez | Case Manager/Care Coordinator | 6704 Nueva Pierda Street Nw, Albuquerque, NM 87120 | 2019-08-28 |
| 1831753508 | Jennifer Lydia Castro | Nurse Practitioner | 8428 Hawk Eye Rd Nw, Albuquerque, NM 87120 | 2019-04-27 |
| 1518425065 | Jean Louise Ramsey | Counselor | Office Alternatives/ The Center for Life Changes, 6300 Riverside Plaza Nw, Suite 100, Albuquerque, NM 87120 | 2019-03-04 |
| 1689147365 | Stairway Recovery, LLC | Family Medicine | 6300 Riverside Plaza Ln Nw Ste 118 #96523, Albuquerque, NM 87120 | 2019-01-06 |
| 1417443276 | Kyle Thomas Lantz | Dentist | 2800-a Coors Blvd Nw, Albuquerque, NM 87120 | 2018-07-05 |
| 1437669736 | Beatrice Ottomanelli | Day Training/Habilitation Specialist | 9180 Coors Blvd. Nw, Apt. 3307, Albuquerque, NM 87120 | 2017-10-02 |
| 1740705516 | Alianza Home Care, LLC | Home Health | 8307 Casa Negra Ct Nw, Albuquerque, NM 87120 | 2017-08-13 |
| 1366963399 | Jamie Farris | Registered Nurse | 8201 Golf Course Road Northwest, Suite D3 #121, Albuquerque, NM 87120 | 2017-06-29 |
| Find all providers in zip 87120 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437659638 | Tender Loving Care Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10213 Belnap Pl Nw, Albuquerque, NM 87114-4682 | 2018-02-15 |
| 1609382910 | Heartwell Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4123 Eubank Blvd Ne, Albuquerque, NM 87111-3421 | 2017-12-21 |
| 1255636221 | Onyx Supportive Living LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5301 Crooked Creek Ave Nw, Albuquerque, NM 87114-4193 | 2011-01-21 |
| 1154625275 | Mandy's Special Farm | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 346 Clark Rd Sw, Albuquerque, NM 87105-7546 | 2011-01-04 |
| 1902072697 | Great Livin', LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4213 Ponderosa Ave Ne, Albuquerque, NM 87110-1031 | 2008-05-02 |
| 1588876932 | Providence Support Services Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8328 Calle Primera Nw, Albuquerque, NM 87120-5386 | 2007-05-05 |
| 1194859306 | The New Beginnings LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6200 Seagull St Ne Ste F, Albuquerque, NM 87109-2547 | 2007-03-16 |
| 1033288626 | Dungarvin New Mexico LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2309 Renard Pl Se Ste 205, Albuquerque, NM 87106-4284 | 2006-11-07 |
| 1992752471 | Transitional Lifestyles Community Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11000 Spain Rd Ne, Blding D, Albuquerque, NM 87111-1883 | 2006-05-28 |
| 1174740856 | Su Vida Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3150 Carlisle Blvd Ne, Suite #206, Albuquerque, NM 87110-1678 | 2007-04-20 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87120 |
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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.