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General NPI Number Information
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NPI Number | 1184979163
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Entity Type | Organization
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Legal Business Name | NATIVE AMERICAN HOME CARE LLC
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | JD MOBILE HOME PARK #15
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City | TSE BONITO
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State | NM
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Zip | 87301
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Country | US
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Telephone | 505-371-5141
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Fax | 505-371-5861
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Provider Business Mailing Address
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Address Line | PO BOX 3107
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City | WINDOW ROCK
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State | AZ
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Zip | 86515-3107
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Country | US
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Telephone | 505-371-5141
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Fax | 505-371-5861
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Authorized Official
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Title or Position | OWNER
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Name | MARIA C CORTEZ
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Credential |
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Telephone | 505-371-5141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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