Provider Demographics
NPI:1003044629
Name:SPECIAL CARE AT HOME, INC
Entity Type:Organization
Organization Name:SPECIAL CARE AT HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-726-2890
Mailing Address - Street 1:PO BOX 4554
Mailing Address - Street 2:
Mailing Address - City:YATAHEY
Mailing Address - State:NM
Mailing Address - Zip Code:87375
Mailing Address - Country:US
Mailing Address - Phone:505-726-2890
Mailing Address - Fax:505-722-8941
Practice Address - Street 1:1020 WEST MALONEY
Practice Address - Street 2:SUITE B
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301
Practice Address - Country:US
Practice Address - Phone:505-726-2890
Practice Address - Fax:505-722-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care