MEDICARE: NAVAEH HOME HEALTH CARE,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1376041731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVAEH HOME HEALTH CARE,LLC

Provider Business Mailing Address
First Line	:	1647 MAHANEY DR TRLR 13
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-4130
Country	:	US
Telephone Number	:	702-854-0337
Fax Number	:

Provider Business Practice Location Address
First Line	:	1647 MAHANEY DR TRLR 13
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-4130
Country	:	US
Telephone Number	:	702-854-0337
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CHRISTINA MARIA MARTINEZ
Credential	:
Telephone Number	:	575-386-3781

Provider Enumeration Date	:	01/30/2018
Last Update Date	:	01/30/2018

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