Radiant Home Care Llc

NPI 1124423454 - In Home Supportive Care - 253Z00000X

NPI Details
NPI 1124423454
Enumeration Date 10/29/2014
Last Updated 10/29/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name DERRICK DERRICK
Position PROGRAM DIRECTOR
Phone (505) 722-9951
Fax
Practice Location
101 SOUTH CLARK STREET
GALLUP NM, 87301, US
Phone (505) 722-9951
Fax
Business Location
101 SOUTH CLARK STREET
GALLUP NM, 87301, US
Phone (505) 722-9951
Fax
Toxanomy
Taxonomy Code 253Z00000X
License State
License Number
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According to our database, Radiant Home Care Llc NPI is 1124423454, taxonomy code is 253Z00000X Radiant Home Care Llc physically located at 101 South Clark Street, Gallup NM, 87301. NPI Number 1033115704 has the healthcare provider type.

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1124423454 NPI number is provided on an as is basis without warranty of any kind. 1124423454 is maintained by the National Plan & Provider Enumeration System. The contents of Radiant Home Care Llc are for informational purposes only.