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NPI Code Detail

MEDICARE: SAFARI HEALTHCARE ASSOCIATE

MEDICARE: SAFARI HEALTHCARE ASSOCIATE
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
1251G00000XCommunity Based Hospice Care Agency
2251J00000XNursing Care Agency
3253Z00000XIn Home Supportive Care Agency
4251E00000XHome Health Agency

General Provider Information

NPI Number : 1447744974
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFARI HEALTHCARE ASSOCIATE
Provider Business Mailing Address
First Line : 2406 WILDWIND RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5503
Country : US
Telephone Number : 800-831-5105
Fax Number : 800-886-6605
Provider Business Practice Location Address
First Line : 2406 WILDWIND RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5503
Country : US
Telephone Number : 800-831-5105
Fax Number : 800-886-6605
Authorized Official
Title or Position : OFFICER
Name : MR. NELSON JUMA KAP-KIRWOK
Credential :
Telephone Number : 616-566-3803
Provider Enumeration Date : 06/18/2018
Last Update Date : 06/18/2018

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