Provider Demographics
NPI:1013910348
Name:BASIN HOME HEALTH INC.
Entity Type:Organization
Organization Name:BASIN HOME HEALTH INC.
Other - Org Name:BASIN HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-325-8231
Mailing Address - Street 1:200 N ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6225
Mailing Address - Country:US
Mailing Address - Phone:505-325-8231
Mailing Address - Fax:505-325-4516
Practice Address - Street 1:200 N ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6225
Practice Address - Country:US
Practice Address - Phone:505-325-8231
Practice Address - Fax:505-325-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251E00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN2145Medicaid
NM321548Medicare ID - Type UnspecifiedMEDICARE HOSPICE NUMBER
NM327104Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER