Provider Demographics
NPI:1457456576
Name:ZIA HOME CARE
Entity Type:Organization
Organization Name:ZIA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREE
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-762-4950
Mailing Address - Street 1:144 SCOTTSDALE DR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-2739
Mailing Address - Country:US
Mailing Address - Phone:505-762-4950
Mailing Address - Fax:
Practice Address - Street 1:144 SCOTTSDALE DR
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-2739
Practice Address - Country:US
Practice Address - Phone:505-762-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility