Provider Demographics
NPI:1447744974
Name:SAFARI HEALTHCARE ASSOCIATE
Entity Type:Organization
Organization Name:SAFARI HEALTHCARE ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:JUMA
Authorized Official - Last Name:KAP-KIRWOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-566-3803
Mailing Address - Street 1:2406 WILDWIND RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-5503
Mailing Address - Country:US
Mailing Address - Phone:800-831-5105
Mailing Address - Fax:800-886-6605
Practice Address - Street 1:2406 WILDWIND RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-5503
Practice Address - Country:US
Practice Address - Phone:800-831-5105
Practice Address - Fax:800-886-6605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care