Provider Demographics
NPI:1518454768
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:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-905-2890
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:505-905-2890
Mailing Address - Fax:505-905-8941
Practice Address - Street 1:22 NORTH LACHEE DR
Practice Address - Street 2:
Practice Address - City:YATAHEY
Practice Address - State:NM
Practice Address - Zip Code:87375
Practice Address - Country:US
Practice Address - Phone:505-905-2890
Practice Address - Fax:505-905-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health