Provider Demographics
NPI:1073007423
Name:NANI'S HOME
Entity Type:Organization
Organization Name:NANI'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:SABORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-904-0131
Mailing Address - Street 1:PO BOX 17749
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85731-7749
Mailing Address - Country:US
Mailing Address - Phone:520-721-1887
Mailing Address - Fax:520-344-8892
Practice Address - Street 1:4267 W CALLE DON CLEMENTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-8500
Practice Address - Country:US
Practice Address - Phone:520-904-0131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness