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General NPI Number Information
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NPI Number | 1366279705
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Entity Type | Organization
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Legal Business Name | SAFARI HEALTHCARE FOUNDATION
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 735 S MESQUITE ST
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City | LAS CRUCES
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State | NM
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Zip | 88001-3622
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Country | US
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Telephone | 800-831-5105
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Fax | 800-831-5105
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Provider Business Mailing Address
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Address Line | 2406 WILDWIND RD
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City | LAS CRUCES
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State | NM
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Zip | 88007-5503
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Country | US
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Telephone | 616-566-3803
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NELSON JUMA KAP KIRWOK
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Credential | RN
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Telephone | 616-566-3803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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