Provider Demographics
NPI:1679945935
Name:ZIA HOME HEALTH
Entity Type:Organization
Organization Name:ZIA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHROBOCINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-662-7361
Mailing Address - Street 1:1475 CENTRAL AVE.
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544
Mailing Address - Country:US
Mailing Address - Phone:505-662-7361
Mailing Address - Fax:505-501-7776
Practice Address - Street 1:1475 CENTRAL AVE.
Practice Address - Street 2:SUITE 125
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544
Practice Address - Country:US
Practice Address - Phone:505-662-7361
Practice Address - Fax:505-501-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM283499DOW251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health