Healthcare Provider Details

I. General information

NPI: 1013910348
Provider Name (Legal Business Name): BASIN HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N ORCHARD AVE
FARMINGTON NM
87401-6225
US

IV. Provider business mailing address

200 N ORCHARD AVE
FARMINGTON NM
87401-6225
US

V. Phone/Fax

Practice location:
  • Phone: 505-325-8231
  • Fax: 505-325-4516
Mailing address:
  • Phone: 505-325-8231
  • Fax: 505-325-4516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNM

VIII. Authorized Official

Name: MARY NELSON
Title or Position: CONTROLLER
Credential:
Phone: 505-325-8231