Healthcare Provider Details

I. General information

NPI: 1497800106
Provider Name (Legal Business Name): RAMAH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 FUHS AVE BLDG 7
GALLUP NM
87301-4402
US

IV. Provider business mailing address

PO BOX 3368
GALLUP NM
87305-3368
US

V. Phone/Fax

Practice location:
  • Phone: 505-863-8940
  • Fax: 505-863-8943
Mailing address:
  • Phone: 505-488-2178
  • Fax: 505-863-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number5753
License Number StateNM

VIII. Authorized Official

Name: MR. KYLE BRIGGS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-863-8940